ESSENTIAL JOB FUNCTIONS

Key Accountability Metrics

• Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers
• Handle escalated calls, resolving more complex customer issues in a one and done manner
• Assist with or deliver training and peer coaching
• Perform quality audits to ensure excellent customer service
• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Intervene with care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
• Assist customers in navigating UnitedHealth Group websites and encourage and reassure them to become self-sufficient
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
• Provide education and status on previously submitted pre-authorizations or pre-determination requests
• Meet the performance goals established for the position in the areas of: efficiency, call quality, provider satisfaction, first call resolution and attendance

PROFESSIONAL EXPERIENCE/QuALIFICATIONS

Requirements and Must Have Criteria

• High School Diploma / GED (or higher) OR 7+ years of equivalent working experience
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• All new hires will be required to successful complete the Customer Service training classes and demonstrate proficiency of the material
• Ability to work full-time, Monday - Friday between 8:30am – 5:00pm including the flexibility to work occasional overtime given the business need

Other Personal Characteristics and Experience

• 1+ years of Customer Service Representative (CSR) experience OR 1+ years of experience in an office setting, call center setting or phone support role
• Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product
• Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed

EDUCATION

• High School Diploma / GED (or higher) OR 7+ years of equivalent working experience

Job Type: Full-time

Pay: $21.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Experience level:

• 3 years

Shift:

• 8 hour shift

Weekly day range:

• Monday to Friday

Work setting:

• Hybrid remote

Experience:

• Call center: 3 years (Required)

Work Location: Hybrid remote in Jacksonville, FL 32256

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