Customer Service Representative - Pomona, CA

Unitedhealth Group Inc. Pomona , CA 91766

Posted 2 months ago

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.

Primary Responsibilities:

  • Answer and document approximately 50 incoming phone calls from customers and providers to identify the type of assistance the customer needs (i.e. benefit and eligibility, registrations, sending referrals, insurance verification and general inquires)

  • Spanish Bilingual agents call mix of 70% English 30% Spanish for typical call volume day.

  • Responding to email correspondence in a timely fashion

  • Ability to convey out of pocket expenses to patients including possible deductibles and collect payment

  • Understanding of clinical information obtained and can expound clinical information to both patient and/or provider

  • Processing of lost, damages, repairs and refunds for hearing devices

  • Request and enter Prior Authorization documentation from healthcare providers

  • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems

  • Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding

  • Meet the performance goals established for the position in the areas of: Key Performance Indicators, member satisfaction and attendance

  • Ensure that the proper plan benefits are applied to each record by using the appropriate processes and procedures (e.g. insurance plan processing policies and procedures, state mandates, CMS / Medicare guidelines, benefit plan documents/certificates, HIPPA)

  • Aptitude for quickly learning and navigating new technology systems and applications.

Required Qualifications:

  • High School Diploma / GED (or higher) OR 10 years of equivalent working experience

  • Ability to work regularly scheduled shifts within our hours of operation (6:00am-6:00pm Monday - Friday) 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

Preferred Qualifications:

  • Associate's degree (or higher)

  • Bilingual in English and Spanish - able to read, write, and speak both fluently

  • 2 years prior experience in an office setting, call center setting or phone support role

  • Previous Healthcare experience (i.e. benefit and eligibility, billing and payments and explanation of benefits)

  • Call Center experience working in a high volume setting

Soft Skills:

  • Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments)

  • Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member

  • Proficient problem solving approach to quickly assess current state and formulate recommendations

  • Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon

  • Flexibility to customize approach to meet all types of member communication styles and personalities

  • Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.

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: UnitedHealth Group, Customer Service, Pomona, CA, Call center

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Technical Planning Specialist Pomona TSD

Edison International

Posted 1 week ago

VIEW JOBS 9/11/2019 12:00:00 AM 2019-12-10T00:00 Energy for What's Ahead Are you looking to make a difference in your career? We're working on smarter grids, cleaner energy and tools to help people manage energy more efficiently. About T&D: Southern California Edison's (SCE's) Transmission and Distribution Organizational Unit (T & D) is responsible for planning, engineering, constructing, operating, and maintaining transmission and distribution facilities throughout the 50,000-square-mile territory. T&D is the steward of roughly $19 billion in assets that safely and reliably deliver electricity to 14 million residents via SCE's 5 million customer accounts. Position Overview This position will be in the Technical Planning-Deteriorated Pole division within Southern California Edison's (SCE) Transmission & Organizational Unit (TDOU). The successful candidate will be responsible for oversight and/or preparation of electrical designs for a number of internal organizations. Typical Responsibilities may include: * Communicate with internal clients including, Distribution Engineering Project Management Organization, Distribution Project Management Organization and Distribution Operations Centers to determine technical requirements regarding the design of new projects. * Define the scope and operational requirements for preparation of preliminary electrical and civil designs. * Create designs for basic infrastructure replacement programs, including capacitors new/replacement, deteriorated poles, deteriorated structures, cable replacement, switch replacement, and ARs new/replacement. * Create designs for minor under-grounding projects; coordinating projects with Distribution Engineering, Civil Construction, PMO, DPMO, Drafting, Scheduling, Construction, Environmental, and other internal organizations to create electrical designs. * Prepare work order documents and drawings, and secure final approval of work order packages. * Order materials and identify expected construction labor and timeframes. * Complete all necessary contracts, invoices, easement requests, apply for necessary permits, FAA approval and submitting environmental reviews to prepare project for eventual construction. * Forward completed work order packages to sponsor organization and updating all internal systems as required. * Assist Designers and other team members with technical issues. * Act as a team facilitator in coordinating efforts of contract planners, engineers, customers, and all other internal sources for the purpose of creating a high quality electrical design in a timely manner. * Maintaining a safety conscious work environment by following Edison safety protocols and safe work practices. * Performing other responsibilities and duties as assigned. * Experience with designing overhead electrical systems. * Knowledge of pole loading requirements. * Experience working with customers, identifying needs and resolving customer issues. * Demonstrated experience, training or education in a technical or mechanical field, including learning or applying technical information related to engineering, drafting, architecture, construction, mapping, design, mechanics, mathematics, science or computers. * Experience managing several projects concurrently, adjusting to shifting priorities, and meeting deadlines. * Experience in SCE systems such as DM, SAP, AUD, CSS, Spida, SpidaMin and knowledge of resource books such as DDS, UGS, ESR, Overhead and Underground Construction Manuals. * Must possess strong oral and written communication skills to interact effectively with clients/ customers. * Ability to collaborate with others. * Ability to gather and analyze information, and make sound decisions independently and in consideration of applicable policies and procedures. * Ability to take initiative and be accountable for the accuracy of information and for achieving results. * Must be proficient in Microsoft Word, Excel, and Outlook. * Able to drive, traverse on uneven surfaces, occasionally lift up to 40 lbs, sit/stand for extended periods of time, work in various weather conditions, and possibly be in remote regions (coast, desert, and mountain) for extended periods of time. Minimum Qualifications * Must be a successful graduate from Service Planner Development Program (SPDP) OR possesses one or more years of experience in Electrical Utility Distribution Design, Transmission Design, Distribution Line construction, or Electrical Engineering discipline. * Must possess a valid U.S. driver's license. Test Requirements * Additional testing may be required as part of the selection process for this position. If testing is required, you will be contacted by Corporate Test Administration upon passing the resume screening process. * Please reference test EEI TECH (Test 5107). * We encourage you to immediately begin preparing for any tests required in this job posting - Link to Information Guides or visit or to access practice tests and test brochures. Username = paper, Password = pen * Candidates who have previously passed test EEI Tech #5107 may not need to retest for this position. Comments * Candidates for this position must be legally authorized to work directly as employees for any employer in the United States without visa sponsorship. * Position will require 30% traveling and being out in the field throughout the SCE service territory. Southern California Edison, an Edison International (NYSE:EIX) company, serves a population of approximately 15 million via 4.9 million customer accounts in a 50,000-square-mile service area within Central, Coastal and Southern California. Join the utility leader that continues to safely deliver reliable, affordable electricity to our customers for over 125 years. SCE is a proud Equal Opportunity Employer and will not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected status.  #LI-MB1 Edison International Pomona CA

Customer Service Representative - Pomona, CA

Unitedhealth Group Inc.