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Client Service Specialist - Remote

Company: UnitedHealth Group
Location: San Jose
Posted on: September 22, 2022

Job Description:

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. 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 A Client Advocate is expected to be the expert point of contact for our clients dedicated in resolving complex questions and inquiries pertaining to member, provider and client matters. They are also responsible for building and maintaining relationships with the clients. The Secondary Support Client Advocate is responsible for utilizing all tools and departments available to ensure client expectations are met while upholding the UHC core values. It can be expected customizations may be built into the role to satisfy client needs. Secondary Support Client Advocates will be expected to carry out; depending on the assigned clients the CA position may include arranging medical appointments for international members for long, short, critical or elective care. -This includes clients, who have chosen concierge like products. In addition, customized services and support may be required as needed to meet client and company requirements. 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 8:00am - 5:30pm. It may be necessary, given the business need, to work occasional overtime. *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Key areas of responsibility and accountabilities:

  • Direct requests related to:
  • Member care pending
    • Immediate VOBs/Authorizations
    • Upfront billing resolution
    • Member refunds
    • Balance billing
    • Provider contract disputes
    • Claim adjudication errors
    • Missing Claims
    • Benefit discrepancy
    • Member Eligibility Issues
    • Member Data issues
    • Escalated/complex claim inquiries
      • Resolution
      • Payment
      • Payment reconciliation
      • Member claim/case reconciliation
      • Confirmation
      • Member eligibility matters
      • Assist in securing documentation requirements Duties and Tasks:
        • Client Advocates are the liaison on all issues affecting members, clients or providers.
        • Coordinate with various internal and external departments to resolve all client, member and U.S. provider inquiries.
        • Bring forth any trend or root cause analysis reviews based on recurring issues that is negatively impacting client satisfaction to the Client Manager and/or Strategic Client Executives.
        • Strategize to improve internal processes and coordinate with the clients as necessary.
        • Work with the Eligibility analyst(s) to identify areas of improvement, resolve issues and long term process improvement.
        • Support the Client Manager(s) and Strategic Client Executives(s) with the operational features.
        • Share feedback for and about client(s) and internal departments with Client Manager/SCE.
        • Develop and maintain provider, client, interdepartmental relationships to increase satisfaction and service. 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) OR equivalent experience
          • 4+ years of experience working in a customer-focused environment Telecommuting Requirements:
            • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
            • Ability to keep all company sensitive documents secure (if applicable)
            • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Soft Skills:
              • Work is frequently completed without established procedures.
              • Ability to work independently
              • Strong time management skills
              • Persistent and demanding when needed to meet client expectations
              • Punctual, preparedness and flexibility
              • Excellent verbal and written communication skills UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status. Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at Learn how Teresa, a Senior Quality Analyst, -works with -military veterans and ensures they receive the best benefits and experience possible. - Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $18.17 - $32.26. The salary range for Connecticut / Nevada residents is $20.00 - $35.53. 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. 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: #RPO, #YELLOW

Keywords: UnitedHealth Group, San Jose , Client Service Specialist - Remote, Other , San Jose, California

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