Senior Customer Service Representative - Atlanta, GA
Senior Customer Service Representative - Atlanta, GAUnitedHealth Group
Atlanta, GA 30328
$1,500 Sign On Bonus For External Candidates
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
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?
As a Senior Customer Service Representative for UnitedHealthcare, you'll be responsible for building trust with members across their health care lifecycle. This function is responsible for assisting members with medical and pharmacy benefits, eligibility, claim resolution, triaging dental and vision issues, assisting with plan selection and enrollment, and improving health care literacy. This function is also responsible for multiple types of claim payment adjustments, including closed claims and denied claims. This function is expected to identify opportunities to resolve member issues timely.
This position is full-time (40 hours/week) Monday - Friday. Overtime may be required. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 10:00pm EST. Our office is located at 2100 River Edge Parkway, Atlanta, GA 30328.
We offer up to 36 weeks of paid training. The hours during training will be 8:00am to 4:30pm Monday – Friday. Training will be conducted in a classroom setting.
- Provides premium level service, removing burdens and providing end-to-end resolution for members. This includes, but is not limited to: Clinical, Financial Decision Support, Behavioral Support, Claims inquiries, and more.
- Answer up to 30 to 60 incoming calls per day from members of our health / dental / vision / pharmacy plans
- Contact care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance.
- Be a single point of contact for highly designated, dedicated UHC national or key account insurance plans.
- Identify the areas of assistance and offer resolution for benefits, eligibility, claims, financial spending accounts, correspondence, OptumRx Pharmacy, Optum Behavioral Health and self-service options
- Educate members about the fundamentals and benefits of managing their health and well-being
- Assist in navigating UnitedHealth Group websites or applications utilizing remote desktop system capabilities
- Construct communication via secure messaging, e-mail or chat
- Research complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues.
- Navigate through multiple platforms and databases to retrieve information regarding medical plans, prescription plans, flexible spending accounts, health reimbursement accounts, vision plans, dental plans, employer-based reward plans, claims submissions, clinical programs, etc.
- Meet the performance goals established for the position in the following areas: effectiveness, efficiency, call quality, member satisfaction, first call resolution, and adherence
- Performs claims adjustments/dollar payments to providers and/or members ultimately impacting UHC costs or commercial account costs
- Effectively refer and enroll members to appropriate internal specialists and programs, based on member’s needs and eligibility using multiple databases
- Must remain current on all communicated changes in process and policies / guidelines.
- Adapt to all process changes quickly, and maintain knowledge of changes at site level and entity level by utilizing all available resources
- Maximize use of community services, support programs, and resources available to member
You’ll be rewarded and recognized for your performance in an environment that will challenge and provide clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- High School Diploma / GED (or higher) or Equivalent work experience
- Minimum of 4+ years of combined education, work and/or volunteer experience
- 2+ years of call center/customer service experience in a professional environment
- Strong computer skills and technical aptitude
- Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.
- Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design
- Social work, behavioral health, disease prevention, health promotion and behavior change (working with vulnerable populations)
- Prior claims processing experience with simple and complex adjustments.
- Sales or account management experience
- Exceptional written and oral communication skills adaptable to live phone conversations as well as e-mail or chat exchanges that drive a trusted relationship
- Propensity to quickly build rapport and respond to members with courtesy and with a sense of urgency
- Talent to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
- Proficient problem-solving techniques to quickly assess current state and formulate recommendations
- Excellent conflict management skills including:
- Professionally and adeptly resolve issues under pressure
- Diffuse conflict and exhibit compassion for distressed members
- Demonstrate personal resilience
- Ability to utilize and navigate multiple systems/platforms
- Strong attention to detail
- Adjustability to environmental change
- Work collaboratively with internal and external partners to achieve enterprise goals
- Model UnitedHealth Group's Principles of Integrity, Core Values and Compliance
- Maintain the confidentiality of sensitive information
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military
Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work. SM
**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.
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: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, health care, office, phone support, training class, hiring immediately. #rpo, #red, Sign-on Bonus