Even if you have no prior experience, we have training classes starting soon to help you build the successful career that you want - apply today!Turn on the news on any night of the week and you're likely to hear about the changes that are sweeping through our health care system. It's dramatic. It's positive. And it's being led by companies like UnitedHealth Group. Now, you can take advantage of some of the best training and tools in the world to help serve our existing and new customers. You'll take as many as 50-70 calls per day from customers who have questions about their health benefits. As their advocate, you'll use your personality and our tools to help them through the health care benefits available to them, including helping them enroll in a new plan. This is no small opportunity.
Purpose of Job:
The purpose of this role is to interact with members regarding medical and pharmacy benefits, eligibility & claims issues and to assist with plan selection and enrollment. This role is expected to identify opportunities to connect members to the best resources to meet their healthcare needs and provide support in order to resolve medical and benefits issues on behalf of a member. The Customer Service Advocate builds trust with members across their health care lifecycle.
Provide in language service to Mandarin, Cantonese, and English speaking customers over the phone
Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow - up with the member
Effectively refers and enrolls members to appropriate internal specialists and programs, based on members needs and eligibility
Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence.
Resolve member service inquiries related to:
Medical benefits, eligibility and claims
Terminology and plan design
Financial spending accounts
Pharmacy benefits, eligibility and claims
Educate members about the fundamentals of health care benefits including:
Managing health and well being
Maximizing the value of their health plan benefits
Selecting the best health plan to meet their health needs
Choosing a quality care provider and appointment scheduling
Premium provider education and steerage
Pre - authorization and pre - determination requests and status
Assist members in appointment scheduling to proactively address gaps in care
Intervene with care on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
Research complex issues across multiple databases and work with support resources to own the resolution of all customer issues and anticipate their future healthcare needs or potential opportunities to improve the experience
Provide education and status on previously submitted pre - authorizations or pre - determination requests
Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance
Maximizes use of community services, support programs, and resources available to members
Bilingual fluency (verbal and written) in Chinese (both Cantonese and Mandarin) and English
1+ years of experience in a professional customer service environment
The ability upon hire to successfully complete the UnitedHealthcare Operations new hire training with a demonstrated proficiency
Associate's Degree or higher
Experience in a Health Care/Insurance environment
Previous experience in translating healthcare-related jargon and complex processes into simple, step-by-step instructions that customers can understand and act upon
Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner and delivering on commitments)
Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
Ability to overcome objections and persuade members to take action / change behavior
Ability to utilize multiple systems / platforms while on a call with a member strong computer skills and technical aptitude
Proficient problem solving approach to quickly assess current state and formulate recommendations
Flexibility to customize approach to meet all types of member communication styles and personalities
Excellent conflict management skills including:
Professionally and adeptly resolve issues while under stress
Diffuse conflict and member distress
Demonstrate personal resilience
Strong verbal and written communication skills.
Solid time management skills
Strong attention to detail
UnitedHealth Group is a team of more than 200,000 people who are building career success through commitment, compassion and a desire to make a difference. Join us. Learn more about how you can start doing your life's best work.SM
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 lifes best
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.
Keywords: UHG, UHC, customer service, Chinese, Mandarin, Cantonese, bilingual, service advocate
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