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


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Customer Service Representative - Pomona, CA

Unitedhealth Group Inc.