UnitedHealth Group
Complex Customer Care Representative - Columbus, OH
At a glance
Location: US-OH-Columbus Map
Posted: 11/07/2019
Closing: 12/06/2019
Degree: Not Specified
Type: Full-Time
Experience: Not Specified
UnitedHealth Group
Job description

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.


Primary Responsibilities:
  • Provide exceptional customer care through taking / making inbound / outbound calls and inquiries from members, providers and other client representatives in regards to benefits, claims, eligibility and provider search
  • Establish and maintain professional rapport with members, clients and providers
  • Coordinate activities between patients, providers, PBMs and other entities related to members care
  • Work with various departments to research claims and resolve outstanding issuesUtilize Plan Analytics and HealthSCOPEs system to accurately document and identify data relevant to the members care
  • Utilize Plan Analytics and HealthSCOPEs system to accurately document and identify data relevant to the members care
  • Work with members to help them understand their benefits and various wellness programs available to them through their plan
  • Assist members with outstanding medical claims and balance due statements
  • Help members locate in - network providers
  • Perform outreach initiatives to members on behalf of client to inform them of new programs and benefits available to them, as well as, activities they may need to complete to remain compliant with the plan
  • Identify and escalate issues and concerns related to member inquiries
  • Other duties as assigned

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) OR equivalent experience
  • Basic knowledge of Microsoft Office software applications including Microsoft Word (opening, finding information, editing, and saving documents), Microsoft Excel (opening, finding information, editing, and saving spreadsheets), Microsoft Outlook (opening, finding information, editing, and saving correspondence) and Microsoft Access (opening, finding information, editing, and saving database)
  • Ability to work Monday - Friday, 10:00 am - 7:00 pm EDT

 Preferred Qualifications:

  • Working knowledge of CPT - 4 coding, ICD9 and medical terminology

Soft Skills:

  • Detailed oriented
  • Effective organizational and prioritization skills
  • Excellent oral, listening and written communication skills
  • Ability to work in a fast paced multi - tasking environment
  • Strong interpersonal skills with ability to function as a positive team member

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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.


Keywords: Customer Service Rep, Call center, CSR

Complex Customer Care Representative - Columbus, OH