About the position
At UnitedHealthcare, we are dedicated to simplifying the health care experience and creating healthier communities. The Provider Customer Services Call and Chat Representative plays a crucial role in supporting providers who care for our members. This position involves responding to inquiries related to benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits (EOB), and behavioral health, either through phone calls or concurrent chat. The role is full-time, requiring 40 hours per week from Monday to Friday, with flexibility to work any of our 8-hour shift schedules during normal business hours of 10:35 AM to 7:05 PM CST. Given the business needs, occasional overtime, weekends, and holidays may be required. The position includes 12 weeks of paid training, conducted virtually from home, with training hours set from 8:00 AM to 4:30 PM CST, Monday through Friday. As a representative, you will serve as an advocate for providers, demonstrating accountability and ownership in resolving issues. You will engage with providers in a multi-channel environment, including calls and chats, and will be responsible for triaging contacts from healthcare professionals, understanding their needs, and providing timely resolutions to their inquiries. In this role, you will research and dissect complex prior authorization and claim issues, collaborating with multiple internal partners to ensure effective communication and resolution. Strong multitasking skills are essential, as you will navigate over 30 systems to extract necessary information across various lines of business. You will also influence providers to utilize self-service digital tools, promoting faster resolutions and enhancing their experience with our services. This position offers a challenging environment with clear direction for success and opportunities for professional development.
Responsibilities
- Serve as the advocate for providers by demonstrating accountability and ownership to resolve issues. ,
- Service providers in a multi-channel environment including call and concurrent chat as required. ,
- Quickly and appropriately triage contacts from healthcare professionals (i.e., physician offices, clinics, billing offices). ,
- Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health). ,
- Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls/messages, escalations, and provider dissatisfaction. ,
- Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner. ,
- Strong multitasking to effectively and efficiently navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types. ,
- Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution.
Requirements
- High School Diploma / GED OR equivalent work experience. ,
- 1+ years of customer service experience with analyzing and solving customer's concerns. ,
- Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications. ,
- Ability to type at the speed of greater than or equal to 35 - 40+ WPM with an accuracy of 90%. ,
- Must be 18 years of age or older. ,
- Ability to work any full-time (40 hours/week), 8-hour shift between the hours of 10:35 AM - 7:05 PM CST from Monday - Friday.
Nice-to-haves
- Prior health care experience and knowledge of healthcare terminology. ,
- Experience in a related environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools.
Benefits
- Comprehensive benefits package ,
- Incentive and recognition programs ,
- Equity stock purchase ,
- 401k contribution