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 Bilingual (Spanish / English) Customer Service and Claims Representative - - 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: 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: 769021 / Latpro-3616556 
Date posted: May-25-2018
State, Zip: Texas, 78201


Cuando se trata de salir adelante y tienes la voluntad de ganar, vamos a llamarlo gran potencial de carrera! If you are located within 50 miles of San Antonio, you will have the flexibility to telecommute* as you take on some tough challenges.You like working with people. Even more so, you like helping them. This is your chance to join a team dedicated to helping our members and their families every day. In this joint role as a Bilingual (Spanish/English) Customer Service and Claims Representative, you'll join us on a mission to not only deliver the best customer service in the health care industry, but the best customer service. Period. Your compassion and customer service expertise combined with our support, training and development will ensure your success. This is no small opportunity. This is where you can bring your compassion for others while doing your life's best work. sm *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. In this role, you play a critical role in creating a quality experience for the callers that you connect with and those that you correspond with. Every interaction gives you that opportunity to improve the lives of our customers and exceed their expectations. You'll spend the majority of your day by responding to calls from our members and help answer questions and resolve issues regarding health care eligibility, claims and payments. You'll also spend a portion of your time reviewing, researching and processing healthcare claims with the goal to ensure that every claim has a fair and thorough review. To learn even more about this position, click here to watch a short video about the job:  (Note: these videos are labeled with our internal job title of Customer First Representatives) This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (7am - 9pm). It may be necessary, given the business need, to work occasional overtime or weekends. This will be a work at home / telecommute role after training, which will be conducted onsite in our office at 12668 Silicon Drive, San Antonio, TX 78249. It may be necessary to attend occasional meetings onsite as well. Please review our telecommute requirements below. Candidates must reside within 50 miles of our office and be available to complete training according to the following schedule: Training Session 1, conducted in our office, with a duration of 8-9 weeks of classroom trainingWork from home for approximately 3 months Training Session 2, conducted in our office, with a duration of 4 weeks Primary Responsibilities:  Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systemsOwn problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the memberReview and research incoming healthcare claims from members and providers(doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan  documents/certificates)Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understandingMeet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance



Spanish Bilingual RequiredPrefer 1 year experience in an office setting,  call center
setting or phone support  role, but not required Previous experience working at home/telecommuting is preferred,
but not requiredAn education level of at least a high school diploma or GED OR
10 years of equivalent working experienceDemonstrated ability in using computer and Windows PC
applications, which includes strong keyboard and navigation skills and learning
new computer programsAbility to multi-task  duties as well as the ability to
understand multiple products and multiple levels of benefits within each
productAbility to work regularly scheduled shifts within our hours of
operation including the training period, where lunches and breaks are scheduled,
with the flexibility to adjust daily schedule, and work over-time and/or
weekends, as neededAll new hires will be required to successful complete the
Customer Service  training classes and demonstrate proficiency of the

Reside within 50 miles of San Antonio, TX with the ability to
attend onsite trainingRequired to have a dedicated work area established that is
separated from other living areasRequired to have a work area in a section of the residence that
provides information privacyRequired to keep all Company sensitive documents
secureRequired to have lockable drawers for the securing of
confidential informationMust live in a location that can receive a UnitedHealth Group
approved high-speed internet connection or leverage an existing high-speed
internet service 
There are several
steps in our hiring process - it's a thorough process because we want to ensure
the best job and culture fit for you and for us. In today's ultra-competitive
job market, the importance of putting your best foot forward is more important
than ever. And you can start by completing all required sections of your
application. (i.e. profile, history, certifications and application/job
questions). Once you submit your resume, you'll receive an email with next
steps. This may include a link for an  on-line pre-screening test(s) (or what we
call an assessment) that we ask you to complete as part of our selection
process.  You may also be asked to complete a digital video interview, but we
will offer full instructions and tips to help you. After you have completed all
of these steps, you can check on the status of your application at any time, but
you will also be notified via e-mail.
Careers at UnitedHealthcare Employer &
Individual. We all want to make a difference with the work we do. Sometimes
we're presented with an opportunity to make a difference on a scale we couldn't
imagine. Here, you get that opportunity every day. As a member of one of our
elite teams, you'll provide the ideas and solutions that help nearly 25 million
customers live healthier lives. You'll help write the next chapter in the
history of health care. And you'll find a wealth of open doors and career paths
that will take you as far as you want to go. Go further. This is your life's
best work.SM
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.
Group is a drug-free workplace. Candidates are required to pass a drug test
before beginning employment.

Keywords: customer
service representative, customer service, CSR, UnitedHealth Group, call center,
UnitedHealthcare, health care, office, phone support, training class,
work at home, telecommute, WAH, San Antonio


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