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Positions in this function are responsible for preparing, processing and maintaining member or group enrollments. Positions may load member or group data into the enrollment database & update the database with changes. Position also responds to member eligibility or group questions and verifies enrollment status. Position will be main point of contact for group customers in regards to enrollment related items. Position will answer incoming calls from customers (members, providers, groups), and is expected to practice superior customer service skills in all communication. Position may work with various types of member correspondence. Position is also responsible for reconciling eligibility discrepancies, analyzing transactional data, and submitting retroactive eligibility changes. Position may also be responsible for inventory control of member and group transactions. Position is expected to meet or exceed department goals for quality and production by adhering to all related department procedures. Position will review and analyze enrollment eligibility error reports and correct the system, based on errors identified.
Applies knowledge/skills to basic, repeated activities.
Demonstrates minimum to moderate depth of knowledge and skills in own function.
Responds to standard requests.
May require assistance in responding to non-standard requests.
Solves routine problems by following established procedures.
May require guidance on prioritizing and setting deadlines for tasks.
Works with others as part of a team.
Follows department guidelines to track and report own work completed.
Ability to adapt to changing processes and procedures.
Practices follow-up skills to ensure customer needs are attended to.
Promotes a professional and positive attitude at all times when dealing with internal resources and external contacts through all forms of communication, including written inquiries and phone calls.
Understands group eligibility requirements; ability to read, interpret, and communicate plan guidelines
High School Diploma / GED
2 years of customer service experience in an office setting, using a computer and telephone as primary instruments for completing work
Experience with Microsoft Word (ability to sort, filter, and create simple documents), Microsoft Excel (ability to sort, filter, and create simple spreadsheets), and Microsoft Outlook (ability to create, respond to, store, and retrieve emails, and use calendar to schedule meetings)
Ability to work Monday Friday between the hours of 8am 5pm; may be required to work outside of these standard business hours, including overtime to meet business needs
Excellent verbal and written communication skills
Time management, organizational, and prioritization skills
Ability to read, interpret, and communicate plan eligibility guidelines to internal and external resources in one on one or group discussions
Able to recognize common words and phrases (red flags) that indicate a customer is becoming frustrated.
Must address the emotional needs of the caller as well as follow effective phone procedures, using words and phrases that convey to the caller that you truly want to help them.
Strong interpersonal skills required at the individual and team level
Energetic, positive, friendly and helpful attitude
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.
Ability to work overtime if necessary.
Ability to work in a continuously changing environment
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 where ever 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
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: UHG, UHC, enrollment, eligibility, enrollment and eligibility, customer service, healthcare
Unitedhealth Group Inc.