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The purpose of this role is to interact with members regarding medical and pharmacy benefits, eligibility and claims issues and to assist with plan selection and enrollment in Medicaid and DSNP Service. 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 Bilingual Chinese & English Phone Advocate builds trust with members across their health care lifecycle.
- Act as a customer advocate and provide in language phone service to Chinese and English speaking customers
- Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow - up with the member
- 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
- Proactively educate members on cover benefits, plan exclusions, and procedures to enhance total customer service experience
- Maximize use of community services, support programs, and resources available to members
- Assist and involve in member retention projects
- Perform other related projects and duties as assigned
- Meet established performance standards
- High School Diploma / GED or higher
- Bilingual fluency (verbal and written) in Chinese (Mandarin and Cantonese) and English
- 2 + years in a Customer Service environment (proven customer service skills and experience working in retail, call centers, or any other professional business setting)
- 1+ year moderate proficiency with Windows PC applications (MS Excel - navigation and creating spreadsheet, Word - navigation and creating documents)
- Ability to learn new and complex computer system applications
- Upon hire you must successfully complete the UnitedHealthcare Operations new hire training and demonstrated proficiency
- Availability to work from 9AM - 6:30PM Monday - Friday and work scheduled shifts within our hours of operation where lunches and breaks are scheduled, with the flexibility to adjust daily schedule
- Associates Degree or higher
- Experience in Health Care / Insurance environment, preferred (familiarity with medical terminology, health plan documents, or benefit plan design)
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 phone and walk - in conversation, printers, and floor activities
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in healthcare here. We serve the healthcare needs of low income adults and children with debilitating illnesses such as Cardiovascular Disease, Diabetes, HIV / AIDS and High - risk Pregnancy. Our holistic, outcomes - based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive Healthcare, Community, and Government partners to heal healthcare and create positive change for those who need it most. This is the place to do your lifes 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.
Keywords: UHG, United Healthcare, Customer Service Advocate, Medicaid and DSNP service, Bilingual Mandarin / Cantonese / English