Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. The Quality Review Specialist monitors adherence to HIPAA and the Centers for Medicare and Medicaid Services (CMS) Guidelines through Quality Monitoring on internal and external Medicare Telesales Agents and Sales Support Representatives. Primary Responsibilities: Monitor agents and representatives for compliance with established processes, policies and guidelines Provide feedback and coaching to agents and representatives based on evaluation results Analyze information and utilize to build recommendations to reduce errors and improve process performance Create and maintain tracking reports in relation to performance Serve as a subject matter expert resource to team members, supervisors and management staff Applies knowledge / skills to a range of moderately complex activities Demonstrates great depth of knowledge / skills in own function Sometimes acts as a technical resource to others in own function Proactively identifies solutions to non-standard requests Solves moderately complex problems on own Works with team to solve complex problems Plans, prioritizes, organizes and completes work to meet established objectives Clear concise communication skills Works independently Demonstrates initiative and innovative thinking
High School Diploma / GED
2+ years of experience in a customer service or Telesales role within a call center
Ability to enter data, save, open, and close within Microsoft Excel
Ability create documents, save, and close documents within Microsoft Word
Ability send and save emails and be able to use the calendar within Microsoft Outlook
Associate's Degree (or higher)
Healthcare and / or insurance experience, knowledge of co-pays, co-insurance, and / or deducible
Quality monitoring experience
Medicare insurance experience
Bilingual fluency in English and Spanish (with the ability to read, write and translate in Spanish and English)
Ability to work independently as well as with others
Ability to work effectively in a fast-paced, changing environment
Physical Requirements and Work Environment:
Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer
Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in healthcare. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our Healthcare system. Ready? It's time to do your life's best work.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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