Claims Representative Customer Service Specialist - Horsham, PA

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You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading health care companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

The Claims Representative Customer Service
Specialist is responsible for answering incoming calls from customers while
ensuring a high level of customer service and maximizing productivity.

 

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 excellent customer service
• Consistently meet established productivity, schedule
  adherence, and quality standards
• Analyze and identify trends and provides reports as
  necessary
• Resolve customer inquiries, explanations of payments, claim
  status, plans, and benefits--through inbound telephone calls (approximately 50
  - 75 calls per day); call resolution may include investigating and reprocessing
  claims.
• Know all insurance plans offered, and be able to process
  claims related to customer calls.
• Express information clearly and succinctly.
• Respond to customers in a polite and courteous manner,
  projecting patience, confidence, knowledge, empathy, engagement, and sincerity
  in tone, words, and actions.
• Establish rapport with callers and inspire confidence to
  positively influence the caller's experience.
• Meet or exceed all quality, schedule adherence, and
  performance measurements.
• Communicate effectively with other departments, providers,
  or health plans to ensure prompt and accurate resolution of calls.
• Learn new plans and keep informed about changes to key claim
  procedures.
• Use computer and Windows applications effectively including
  the Microsoft Office product suite; be able to learn new computer applications
• Input data into multiple systems efficiently and accurately,
  using dual screen processing in a paperless environment
• Extensive work experience within own function.
• Work is frequently completed without established procedures.
• Works independently.
• May act as a resource for others.
• May coordinate other's activities.

Qualifications:

• 2+ years of Call Center Customer Service OR Office experience required
• An education level of at least a high school
  diploma or GED OR 10 years of
  equivalent working experience
• Familiarity with computer and Windows PC
  applications, which includes the ability to learn new and complex computer
  system applications
• Basic ability with MS Word and Excel
• Available to work 40 hours per week anytime within
  the operating hours  of  the site
• 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
• Authorization to work in the United States

 

Assets/Preferred:

• Health Insurance
  experience
• Medicare
  knowledge
• Claims
  processing experience
• College
  degree
• MS Outlook experience
• Bilingual in English and Spanish
• Call center experience
  

 

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
  
  

UnitedHealth Group is working to create the health care system of tomorrow and you can help. Already Fortune 17, we are totally focused on innovation and change.  We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed.  Join with us and start doing your life's best work. SM

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.