Challenge can often be its own reward. But why settle for just being challenged when you can also be nurtured, mentored and supported as you make an impact in a fast paced career? At UnitedHealthcare, part of the UnitedHealth Group family of businesses, you can have all of the above, every day. Now, you can take advantage of some of the best training and tools in the world to help serve our existing and new customers. As a Bilingual English & Spanish Senior Customer Service Representative, you'll provide our members with the information they need to make better decisions about their health, helping them get access to the right care the first time. Every day, you'll provide compassionate and empathetic support to 50 to 70 callers providing guidance, support, and resolution for escalated issues. This is no small opportunity. This is where you can bring your compassion for others while building your career.
Positions in this function are responsible for providing expertise and customer service support to members, customers, and/or providers. Direct phone-based customer interaction to answer and resolve a wide variety of inquiries.Primary Responsibilities:Demonstrate knowledge of applicable health care terminology (e.g., medical, dental, behavioral, vision)Demonstrate knowledge of applicable products/services (e.g., benefit plans, disability, COBRA, FSA, HRA)Obtain and apply knowledge of benefit structures/designs for contracted or acquired companiesEnsure compliance with applicable legal/regulatory requirements (e.g., HIPAA, state/regional requirements)Maintain knowledge of information/process changes due to healthcare reform, referring to applicable company resources (e.g., dependent age, removal of lifetime limits, free preventive care services, Medical Loss Ratio)Demonstrate knowledge of established workflows and support processes (e.g., available resources, internal/external business partners, points of contact)Demonstrate knowledge of relevant internal processes impacting caller issues (e.g., claims processing, auto-adjudication)Identify inaccurate/inconsistent information found in systems/tools, and communicate to appropriate resources (e.g., IBAAG, SOP, AYS, SPDs, policies/procedures)Communicate common problems/questions presented by callers to appropriate Subjects Matter Experts, to drive continuous improvementEducate callers on available products/services (e.g., features, functionality, options, additional offerings, preventive services, age-related services)Educate callers on self-service resources available to them, and on their responsibilities with regard to their health care coverageRefer callers to other resources applicable to their questions/issues, where appropriate (e.g., pharmacists, prior authorizations, billing department)Review/analyze phone support data/metrics and communicate patterns/trends to internal stakeholders, as needed (e.g., leadership, Subject Matter Experts, business partners)Provide training/mentoring to other team members, as needed (e.g., new-hires, refresher training)Participate in customer site visits, as needed (e.g., to obtain feedback, provide education, clarify support processes, highlight company performance)
Required Qualifications: High School Diploma / GED or higherMedical OR Healthcare experience 1+ years of call center experience Bilingual in English and SpanishFamiliarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applicationsExperience translating health care-related jargon and complex processes into simple, step-by-step instructions customers can understand and act uponAbility to work Monday – Friday from 10:30 AM to 7:00 PMPreferred Qualifications:Knowledge of billing/finance and eligibility processes, practices and conceptsSoft Skills:Demonstrated ability to listen skillfully, collect
relevant information, build rapport and respond to customers in a
compassionate mannerProficient conflict management skills including the ability to resolve stressful situationsCareers 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.SMDiversity 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: UnitedHealth Group, Las Vegas, Bilingual, Senior Customer Service, Call Center, Member Support, Provider Support