UnitedHealth Group Looking for Customer Service Representative – Remote in Washington, DC at Washington, DC Full Time

If you are located within Washington D.C, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

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

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST. It may be necessary, given the business need, to work occasional overtime.

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Respond to and resolve, on the first call, customer service inquiries and issues from several sources (Provider, Member, Customer)
• Research complex issues using multiple UMR proprietary applications and databases and work with appropriate internal support resources to resolve customer issues and/or partner with Supervisor to resolve escalated issues
• Help members locate providers, understand their benefit plan and answer questions related to processed claims
• Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers, members, and customers in a timely manner.
• Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls, escalations, and provider dissatisfaction.
• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures to adjudicate complex claims (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
• Strong multitasking to effectively and efficiently navigate more than XX systems to extract necessary information to resolve and
• Meet the performance goals established for the position in the areas of: quality, productivity, member satisfaction and attendance

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.

Required Qualifications:

• High School Diploma / GED (or higher)
• 1+ years of customer service experience analyzing and solving customer’s concerns

Preferred Qualifications:

• 2+ years customer service OR experience in the healthcare industry

Soft Skills:

• Negotiation
• Active Listening
• Agility/Flexibility
• Cultural Sensitivity
• Conflict Resolution
• Patience/Resilience
• Empathy/Sensitivity
• Verbal/Written Communication
• Disability & Diversity Awareness
• Effective time and resource management

Telecommuting Requirements:

• Reside within Washington D.C
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Careers with UnitedHealthcare. Let’s talk about opportunity. Start with a Fortune 5 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

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves 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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