Position Description
The role of the Customer Care Professional is to build trusted relationships with members across their health care lifecycle. This is done by assisting in plan selection and enrollment, educating members about management of their health and well being, helping members to maximize health plan benefits and personal health care dollars and owning customer service inquiries through to resolution.
Responsibilities:
Assist members with selecting the best benefit plan options available to them through the enrollment process, including enrollment in specialized care programs
Resolve member service inquiries related to:
Medical benefits, eligibility and claims
Financial spending accounts
Pharmacy benefits, eligibility and claims
Correspondence requests
Educate members about the fundamentals of consumer-driven health care including:
Managing health and well being
Maximizing the value of their health plan benefits
Choosing a quality care provider
Premium provider education and steerage
Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
Help members navigate myuhc.com and other UnitedHealth Group websites
Intervene with care providers on behalf of the member
Research complex issues across multiple databases and work with support resources to resolve member issues
Assist members with provider appointment scheduling
Connect members with internal specialists for assistance when needed
Partner with others to resolve escalated issues
Provide education and status on previously submitted pre-authorizations or pre-determination requests.
Qualifications:
Minimum 1 year Customer Service experience
An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
Healthcare experience preferred
Expert need identification, intake and listening skills
Strong verbal and written communication skills
Strong time management skills
Strong problem solving approach to quickly assess current state and formulate recommendations
Quickly identify requested information and anticipate future needs
Ability to translate jargon and complex processes into simple, step-by-step instructions members can understand and act upon
Ability to overcome objections and persuade members to take action / change behavior
Flexibility to customize approach to meet all types of member communication styles and personalities
Excellent conflict management skills including:
Professionally and adeptly resolve issues while under stress
Diffuse conflict and member distress
Demonstrate personal resilience
Strong attention to detail
Associate degree or higher preferred
Successful completion of United Health Care Operations CCP new hire training and demonstrated proficiency required
Quality focused
Physical Requirements and Work Environment:
Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.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.