Customer Service Claims Representative - Green Bay, WI - Full-time / Part-time

You want more challenge. You want more opportunity. You want more reasons
to head in to work every day.  We want more people like you. UnitedHealth
Group Customer Care Centers are home to a team that lives and breathes
restless. We're still finding ways to outdo what we did yesterday. And that's
what makes us one of the fastest growing businesses in the country and the
world. Now it's time to discover how our continuous expansion can drive
incredible growth in your career.

Our Customer Service/Claims Representatives work hard to build
trusted relationships with members across their health care lifecycle. This
includes educating members about management of their health and well-being,
helping members to maximize health plan benefits, and personal health care
dollars and owning customer service inquiries through to resolution.

Responsibilities:

• Respond to complex customer calls

• Resolve customer service inquiries which could include:

• Benefit and Eligibility information

• Billing and Payment issues

• Customer material requests

• Physician assignments

• Authorization for treatment

• Explanation of Benefits (EOB)

• Provide the very best customer service to internal/external customers. (Approximately 50-60 calls per day).

• Constantly meet established productivity, schedule adherence, and quality standards

• Processes claims according to specified procedures and standards, meeting all position production and quality standards.

• Recognizes
  when to refer complicated claim situations to the various areas,
  outside firms and organizations.  Submits and monitors claims referred
  to internal support units.

• Determines if third party recovery or reimbursable compensation potential exists.

• Handles
  complex claim situations.  Analyzes and resolves problems from
  customers and providers.  Selects and explains the best solution for the
  problem.

• Project work as assigned.

• 1
  year of customer service experience analyzing and solving customer
  problems, OR 1 year of experience in an office setting environment using
  the telephone and computer as the primary instruments to perform job
  duties
• An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
• Authorization to work in the United States
• Available to work 40 hours per week anytime within the operating hours of the site
• Familiarity
  with computer and Windows PC applications, which includes the ability
  to learn new and complex computer system applications
• Ability to navigate a computer while on the phone
• Ability
  to multi-task, this includes ability to understand multiple products
  and multiple levels of benefits within each product
• Ability to remain focused and productive each day though tasks may be repetitive

• 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

Diversity creates a healthier atmosphere: All
qualified applicants will receive consideration for employment without regard
to race, color, religion, sex, national origin, protected veteran status, or
disability status. 

UnitedHealth Group is a drug-free workplace. Candidates are required to
pass a drug test before beginning employment. In addition, employees in certain
positions are subject to random drug testing.