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.SM
We are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good. Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed.
The Call Center Associate is highly skilled and an experienced customer service representative who is responsible for answering incoming calls from customers while ensuring a high level of customer service and maximizing productivity.
Responsible for answering up to 50-70 incoming phone calls per day from both our English speaking and Spanish speaking customers and identify the type of assistance the customer needs
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
Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to include managing their health and well-being by selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider
Intervene with care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
Assist customers in navigating myuhc.com and other UnitedHealth Group websites and encourage and reassure them to become self-sufficient
Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues.
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
Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
- 1+ year of Call Center experience with inbound calls
- 1+ year of experience with Healthcare Claims, Benefits, &/or Authorizations (i.e. in a doctors office, HMO, etc.)
- Must be bilingual / fluent in English/Spanish in order to be considered for this position.
- Able and willing to adjust daily schedule and work over-time and/or weekends, as needed
Helping create positive customer experiences for providers and our members can drive your sense of impact and purpose. Join us as we improve the lives of millions. Learn more about how you can start doing your life's best work.(sm)
- High school diploma or GED OR 10 years of equivalent working experience
AppleCare Medical Management Group was incorporated in 2003. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.
For more information on our Internal Job Posting Policy,
Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment
Job Keywords: Healthcare Call Center Assoc, Bilingual, Spanish, La Palma,
California, CA, Call Center, Claims examiner, Medical claims, Health plans, Benefits, customer service
See job description.