Customer Specialist

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM

Positions in this function are also responsible for keeping their existing customers while taking on the additional responsibility of becoming a member of the Mentoring Team, and mentoring and supporting new customer specialists. Positions in this function are also responsible for first-level response and resolution of escalated issues with external and internal customers. Responsible for the overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership. This position will continue to report their current Customer Specialist Manager

This position is full – time (40 hours / week), Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 AM – 8:00 PM EST. It may be necessary, given the business need, to work occasional overtime.

We offer on the job/ shadow based training. It would be an 8 hour shift Monday-Friday 8am-8pm EST. Duration for training is based on the individual candidate and their needs. More details on the training will be discussed further during the interview process by the hiring manager. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

  • Works independently to manage own tasks and applies knowledge / skills to a range of complex activities
  • Demonstrates great depth of knowledge/skills in own function and increased knowledge / skills in other functions such as coding, networks, integration, HRA, HCR regulations, etc.
  • Proactively identifies non – standard requests and potential problems; investigates and solutions using defined processes, expertise and judgement
  • Resolution is determined by use of knowledge, research, and internal contacts
  • Identify potential claim and / or customer service issues during implementation and create a plan to ensure risk is minimized
  • Consults with key business partners outside of team to ensure benefit intent is understood based on source documents and output matches (coding, SAE, PNO, network services, integration support)
  • Serve as the liaison to a complex customer base to manage first level response and resolution of escalated issues with external and internal customers
  • Identify and resolve operational problems using defined processes, expertise and judgment
  • Investigate claim and / or customer service issues as identified and communicate resolution to customers
  • Responsible for maintaining customer’s medical plans installation documents
  • Responsible for testing customer benefit changes in CPS
  • Create and update HPDB’s
  • Identify the need for and providing specific and remedial training to processors or CFR’s
  • Large claim file reviews
  • Monitor large dollar claims – for stop loss
  • Respond to SBA and external vendor audits
  • May act as a resource for others
  • May coordinate other activities
  • Responsible for coaching new Customer Specialists

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)
  • 3+ years of Customer Service experience with analyzing and solving customer problems
  • Experience with UMR CPS (Must be within UMR business line)
  • Experience with working within cross functioning departments of UMR
  • Current / previous experience as a Service Account Manager Associate within UMR
  • Experience with CPS medical installation documents and implementation checklists
  • Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00 AM – 8:00 PM EST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

  • Experience with using Microsoft Word (creating and editing documents), Microsoft Excel (creating basic formulas, creating, and managing pivot tables), and Microsoft Outlook (creating and sending emails)

Telecommuting Requirements:

  • Ability to keep all company sensitive documents secure (if applicable)
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / New Jersey / New York / Washington / Rhode Island residents is $22.45 – $43.89.Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

APPLY HERE