Customer Service Representative - National Remote

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM

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! We provide the support and structure, you provide the interest and motivation.

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 role as a Customer Service 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

In this role, you play a critical role in creating a quality experience for the members and providers we support by providing accurate, professional personalized, compassionate help, guidance and support focusing on first call resolution in a high volume, fast - paced environment. 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.

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 8:00 AM - 8:00 PM EST. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of paid on-the-job training (Duration based on needs of candidate). The hours during training will be any 8-hour shift between 8:00 AM - 8:00 PM CST from Monday - Friday. Training will be conducted virtually from your home.

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Address and resolve Customer Service calls empathetically and professionally.
• Accurately document, research and resolve all inquiries ensuring documentation is clear and complete.
• Respond and resolve inquiries on the first call by identifying the topic and type of assistance the caller needs (benefits, eligibility, material requests, physician assignments, claims, billing and payment, etc.) utilizing all resources available.
• Monitor and expeditiously close any inquiries which require follow up based on departmental guidelines.
• Refer unresolved inquiries / Grievances to designated areas for investigation.
• Own problem through resolution on behalf of the caller in real time or through comprehensive and timely follow up with support resources / partner with others to resolve complex issues.
• Intervene with care providers (doctor’s offices) on behalf of participants (assist with appointment scheduling, access to care issues, etc.).
• Assist providers with all levels of requests, ability to problem solve through resolution.
• Coordinate with field Care Team staff for issue elevation and resolution.
• Maintain up - to - date knowledge and understanding of claims policies, regulatory requirements and guidelines.
• Successfully utilize all resources available to handle inquiries / multi - task.
• Meet or exceed individual and departmental quality standards / achieve performance goals.
• Adhere, keep updated and utilize all company guidelines, policies and procedures.
• Prioritize and adjust individual workload to ensure departmental goals are met.
• Assume responsibility for ad hoc projects or functions that promote the future success of the operation.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED OR 10+ years of equivalent working experience
• Minimum 2+ years of Customer Service experience
• Ability to successfully complete the Customer Service training classes and demonstrate proficiency of the material
• Ability to type at a minimum speed of 40+ WPM (words per minute)
• Ability to work regularly scheduled shifts within the hours of operation 8:00 AM - 8:00 PM EST including the flexibility to work occasional overtime based on business need
• Availability to work 2x evening shifts per week (typically 11:00 AM - 8:00 PM EST)
• Availability to work 3x Holidays not observed by Client (Day after Thanksgiving, Christmas Eve, New Year’s Day)
• Must be 18 years of age OR older

Preferred Qualifications:

• 1+ years of prior experience in an automatic call distribution call center setting
• Knowledge of CPT / ICD10 coding
• Knowledge of Medicare / Medicaid guidelines

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

• 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, consistently meeting commitments)
• Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
• Proficient problem - solving approach to quickly assess current state and formulate recommendations
• Proficient in translating healthcare - related jargon and complex processes into simple, step - by - step instructions customers can understand and act upon
• Flexibility to customize approach to meet all types of member communication styles and personalities
• Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience
• Ability 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 needed

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.00 - $28.27 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

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