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Customer Service Representative - Southfield, MI-314740: UnitedHealth Group

Job ID314740
Company NameUnitedHealth Group
Job CategoryCustomer Service; Healthcare
LocationSouthfield, MI
Position TypeFull-Time, Employee
Experience1-2 Years Experience
Date PostedNovember 5, 2009 (Reposted Nov 6)


Job Category:
Customer Service

Reference Code:
314740

Position Type:
Full-time, Regular




UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.

Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.

Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?


Customer Service Representative - Southfield, MI-314740

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

Description

AmeriChoice, a UnitedHealth Group company, is a recognized leader and innovator in providing managed health care solutions to its membership, which includes Medicaid, Medicare and SCHIP beneficiaries. With over a decade of growth and success, we are poised for continued expansion of our services in this dynamic marketplace. Our commitment to this specialized market makes a genuine difference in the lives of our 1.8 million members. Join us, do rewarding work, and build a great career.
Customer Service Representative - Southfield, MI
Position Description:
Answer simple incoming calls from providers and members while ensuring a high level of customer service while maximizing productivity with minimum downtime. Resolve basic types of customer service inquiries.
Primary Responsibilities:
  • Respond to:
    • Benefits calls
    • Eligibility calls
    • Member material requests
    • Provider look-up calls
    • Authorization calls
    • Basic member administration calls
    • Explanation of Benefits
  • Provide excellent customer service to both members and providers by:
    • Quickly and accurately identifying and assessing individual provider and member needs
    • Taking appropriate action steps to satisfy those needs
    • Solving problems systematically
    • Participating in proactive outbound call program to ensure customer satisfaction, when applicable
    • Responding to customers in a polite and courteous manner, especially in stressful situations
    • Projecting patience, empathy, caring, and sincerity in voice tone and words
    • Establishing rapport over the phone quickly, and remain positive and upbeat over prolonged periods of customer service
    • Expressing thoughts and information clearly and succinctly
    • Inspiring confidence and positively influence the behavior, actions, and thoughts of others
    • Communicating unpleasant or negative information in a tactful manner
    • Ensuring the average call monitoring score over the previous six months meets or exceeds quality standards
    • Ensuring proficiency in all product lines instructed in classroom training
    • Consistently meeting established productivity, schedule adherence, and quality standards
    • Adhering to quality improvement initiatives
    • Learning new skills, and retain large amounts of information, facts, rules, procedures, and codes
    • Being flexible, adjusting quickly, and reacting positively to change
    • Demonstrate the ability to build and maintain productive working relationships with others and contribute as an effective team member
    • Establishing and maintaining control of inbound calls using a well-organized call structure
    • Responding in writing to member/provider basic correspondence using pre-approved letters
    • Processing claims requiring standard co-pay resolution
    • Identifying and resolving claims with eligibility discrepancies
    • Identifying when to route claims to internal or national queues
    • Processing claims requiring suspect duplicate resolution
    • Performing same day void, stopping payment, and/or deleting before issue transaction
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered

Qualifications

Qualifications:
  • 1 + years customer service experience in a call center
  • High School Diploma or GED is required
  • MS/Office (Word, Excel & Outlook) skills are required
  • Must be able to work with established quality and productivity standards
  • Must be able to adhere to a attendance schedule
  • Bilingual skills are preferred (English / Spanish) or (English / Arabic)
  • Claims process background is preferred
  • Experience with medical terminology is a plus
  • Coding background is preferred
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.In addition, employees in certain positions are subject to random drug testing.




Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.



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