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
Positions in this function are responsible for first - level response and resolution or triage of escalated issues with external and internal customers. Responsible for the overall delivery of benefits and services by providing on - site support and guidance to assigned client. Acts as outward - facing, dedicated resource for assigned account, with direct client contact for complex escalations. Builds relationships with employer / group client (not individual members) and serves as the primary point of contact for day - to - day operational service delivery. Represents client internally and coordinates with other functions to infuse call / claim service delivery expectations, complete projects, and address ongoing service needs.
- Investigate and manage escalated claim / call / appeals issues through root cause analysis and communicate outcome (in person, telephonically or via written communication) to internal partners or external clients
- Serve as liaison between internal customers and external customers to facilitate call and claim issue resolution and respond to inquiries
- Track, trend and proactively review accounts for service opportunities
- Drive process improvement based on trend analysis
- Identify and report system problems in relation with benefit installation and interpretation
- Document and track all issues and activities accurately within ETS - BE
- Complete and deliver complex Performance Guarantee reporting to internal and / or external customers
- Create and deliver quarterly and annual service performance scorecards
- Drive excellence in service within organization and across organization by providing feedback to Operations on service opportunities
- Attend Account Management and / or client meetings representing call and claim and host and/or lead internal meetings with operations leaders to share Voice of the Customer feedback
- Provide consultative support to strategic business partners, assisting in delivery of services for new / existing business implementation, i.e., engaging in conversations regarding past experience or potential issues around benefit or claim processing
- Develop and deliver customer specific (benefit, claim, and cultural) training to Transaction and Customer Care organization
- Support Open Enrollment (i.e. updating open enrollment database, training call teams, benefit fairs, vendor summits etc.)
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 / GED (or higher)
- Experience as a Service Account Manager, Client Relationship Manager, or related experience
- Experience with operational processes and systems (i.e. calls, claims, appeals etc.)
- Experience in health insurance industry, products and services, and the managed care environment
- Experience with Microsoft Office suite – Microsoft Word (create and edit correspondence), Microsoft Excel (ability to create, edit, and sort spreadsheets, and work with formulas), Microsoft PowerPoint (ability to create and edit slides, and visually present data), and Microsoft Outlook (email and calendar management)
- Ability to travel up to 25% of the time per business needs
- Associate’s degree (or higher)
- Strong knowledge of medical terminology, referral and authorization practices, standard - coding methodologies (CPT, ICD-10, HCPCS, and revenue), and Health Care Reform requirements
- Ability to effectively manage in - person and written communications with the client
- Ability to navigate and learn new and complex computer system applications
- Ability to multi - task including the ability to understand
- Experience working in a fast - paced environment
- Works independently
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: UHG, UHC, Service Account Manager, Onsite Client Manager, Client Relationship Manager, health insurance industry, managed care