Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
The role of the Services Advocate is to build trusted relationships with members across their health care lifecycle. This is done by assisting members with their customer service needs, educating members about management of their health and wellbeing, helping members to maximize health plan benefits and personal health care dollars and owning customer service inquiries through to resolution. Another purpose of this position is to support the mission, vision and values of the organization and department through quality, service, innovation, integrity, teamwork, and dignity/respect. The employee specifically contributes to organizational/departmental success through:
- Member satisfaction with Optum Health Collaborative Care, guest/member retention, and guest/member contacts/information gathering
- Policy/process identification and improvement
- Ongoing quality improvement for customer care interactions
- Providing Excellent Customer Care to our guests/members
- Available, as scheduled, to respond to calls from customers regarding claims payments, benefits, eligibility, and certification issues.
- Investigate issues and document steps taken to achieve resolution.
- Manage resolution of issues through contact with the claims department, case management, and external payers ultimately achieving a positive outcome.
- Investigate and handle retro-certification activities, as required for resolution of customer issues.
- Respond to customers regarding status of formal complaints or appeals.
- Other duties may apply.
This role is equally challenging and rewarding. It requires fluency in computer navigation and toggling while you confidently and compassionately engage in dialogue with the caller. Be assured that our training will provide you with knowledge of the various products, plans and levels of benefits available to members and you'll soon find yourself creating positive experiences and earning the gratitude of callers on an hourly basis.
***ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION***
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.
- High school diploma or higher degree completed
- 1+ years of experience in a Call Center setting
- Knowledge of medical or health insurance terminology
- Intermediate Windows PC navigation proficiency or higher and ability to navigate in multiple systems
- Available to work (40 hours/week) Monday- Friday. Flexible to work any of our 8 hour shift schedules during our normal business hours of (10:00am to 10:00pm) (Need to be available for a rotating schedule on Saturdays)\
- Bilingual Spanish/English proficiency
- 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.
- Associates Degree
- A clerical or administrative support background
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
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.
Job Keywords: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, Optum, health care, office, phone support, training class, San Juan, PR, Puerto Rico, SSPR, #RPO