Manage overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership Provide expertise and customer service support to members, customers, and/or providers Identify and resolves operational problems using defined processes, expertise, and judgment Investigate claim and/or customer service issues as identified and communicate resolution to customers Youll be rewarded and recognized for your performance in an environm... more details
If you are located within County or any of the contiguous counties located in the Service Delivery Area, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. You may be required to report to an office or offsite event as assigned by your manager.
At UnitedHealthcare, were 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 lifes best work.SM
This position is full-time, Monday - Friday.Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm. It will be necessary to work at least one split shift a month on a rotational basis. The hours for the split shift are 8:00am to 1:00pm and then 5:00pm to 8:00pm. Our office is located at 2950 North Loop W, Suite 200Houston, TX .
We offer weeks of on-the-job training. The hours of training will be aligned with your schedule.
*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.
Primary Responsibilities:
- Manage overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership
- Provide expertise and customer service support to members, customers, and/or providers
- Identify and resolves operational problems using defined processes, expertise, and judgment
- Investigate claim and/or customer service issues as identified and communicate resolution to customers
Youll 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 equivalent work experience
- Must be 18 years pf age OR older
- Current Community Health Worker Certification or obtain within 6 months of hire
- 2+ years of customer service experience with an MCO, medical office, hospital/facility setting, home health or pharmacy setting
- Microsoft Office including Microsoft Word (create correspondence and work within templates), Microsoft Excel (ability to sort, filter, and create simple spreadsheets), Microsoft Powerpoint (create & present); Microsoft Outlook(Create emails and send emails)
- Experience dealing with difficult individuals who are aged and/or disabled and have the ability deescalate conversations to ensure appropriate levels of service are communicated in a professional manner at all times.
- Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm. It will be necessary to work at least one split shift a month on a rotational basis. The hours for the split shift are 8:00am to 1:00pm and then 5:00pm to 8:00pm.
Preferred Qualifications:
- 1+ years of claims processing experience
- 1+ years of Medical Terminology
- 1+ years of Medicaid and Medicare Knowledge
- UNET, COSMOS, FACETS or NICE claims platforms experience
- Project management experience
- Bilingual able to read, speak, and write other languages
- Must be able to multitask on multiple web-based systems
Telecommuting Requirements:
- Reside within Harris County and Surrounding Counties
- 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:
- Possess Excellent verbal and written communication skills
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location, and incomedeserves 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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