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 Customer Service Representative--Call Center - WellMed - San Antonio, TX - SAN ANTONIO, Texas, United States

Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Existing work authorization required for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Administrative - Other
Administrative - Receptionist/Secretarial
Customer service & support
Travel: Minimal 
Accept candidates: from anywhere 
Languages: English - Fluent
Spanish - Fluent
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 753190 / Latpro-3597239 
Date posted: Feb-14-2018
State, Zip: Texas, 78201


The Care Team Associate (CTA) will effectively support the successful implementation and execution of all pharmacy programs and processes.  The Care Team Associate will provide support to the pharmacy staff to ensure applicable program processes and operational responsibilities are met. The Care Team Associate will be responsible for determining eligibility of members applying for the Medical Assistance Program (MAP). This position will also provide support in troubleshooting any member issues identified by the pharmacy staff during member outreach calls.   Primary Responsibilities: Receives and responds to escalated pharmacy inquiries from all communication venues: e.g. phone queue, portal, claim queue, department e-mail box or fax Coordinates and assists initial screening of MAP enrollment requests via all communication venues; as well as administrative preparation for clinical staff Conducts in-bound and out-bound calls for program requirements including, but not limited to: patient scheduling, surveys/screenings, reminder calls, census management and distribution of materials to appropriate clinical personnel or patients Initiates the process of granting, modifying, denying, or terminating assistance, or referring applicants to other agencies for assistance Collects and maintains eligibility information in an appropriate and confidential manner Interviews applicants by phone for program requirements Enters all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly Exhibits excellent phone and communication skills while providing complete and accurate information to customers Requests additional or supplemental information via correspondence in order to complete applications Adheres to assigned schedule and quality metrics Uses a multi-lined telephonic system to answer calls regarding eligibility requirements Maintains abreast of program qualifications in order to troubleshoot problems that may arise during the eligibility process Completes calls/assignments and ensures census management, productivity weekly and monthly standards are met Provides clerical and/or administrative support to clinical staff and managers for special studies, projects and reports Provides excellent customer service by serving as a resource to all internal and external customers Attends required meetings and participates in special committees as needed Performs other duties as assigned


Required Qualifications:

High School Diploma or GED required
Two years of administrative support experience
At least six months experience in a medical setting
Basic knowledge of Microsoft Office products, including Word and Outlook
Must be able to work independently, with some supervision and direction from manager
Possesses medical terminology knowledge base
Must possess and demonstrate excellent organizational skills, customer service skills, and verbal and written communication skills to include but not limited to patients, physicians, clinical staff, contracted providers and managers
Must maintain and demonstrate a high degree of professionalism to include both personal conduct and appearance at all times
Must maintain strict confidentiality at all times to include but limited to patients and coworkers
Must comply with all organizational policies regarding ethical business practices
Must adhere to all department policies and procedures
Preferred Qualifications:

Certified Medical Assistant training or certification preferred
Two or more years of experience in a physician's clinic or hospital preferred
Bilingual language proficiency (English/Spanish)
Ready to answer the call? Take this opportunity to do your life's best work.(sm)Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.SM
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.
Job Keywords: customer service, call center, intake, prior authorization, medical assistant, administrative, clerical, coordinator, claims, San Antonio, TX, Texas


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