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Hours Full-time, Part-time
Location Franklin, TN
Franklin, Tennessee

About this job


Position Description:

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.(sm)

Primary Responsibilities:
  • Serve as the liaison to a complex customer base to manage first level response and resolution of escalated issues with external and internal customers
  • Identifies and resolves operational problems using defined processes, expertise and judgment 
  • Investigate claim and/or customer service issues as identified and communicate resolution to customers
  • Provide feedback to team members regarding improvement opportunities
  • Provides expertise and customer service support to members, customers, and/or providers 
  • Manages Client relationships for both internal and external clients
  • Consistently achieves quality metrics expectations as set by client
  • Provides invoicing and reporting for assigned clients
  • Has knowledge of workflow management across the CoE organization (AWA, Suspense, Research, PRA, Client AR, Open Credits)
  • Process Documentation for all clients and processes
  • Has access to multiple client systems and is able to efficiently navigate 
  • Manages assigned inventory 
  • Basic claims writing fundamentals
  • Responsible for first-level response and resolution of escalated issues with external and internal customers. 
  • Responsible for the overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership.
  • Extensive work experience within own function.
  • Work is frequently completed without established procedures.
  • Works independently.
  • May act as a resource for others. 
  • May coordinate others activities.

Requirements


Requirements:

  • High diploma or GED. 
  • Must be able to work an 8 hour shift between 7am and 6pm Monday through Friday 
  • Intermediate level of proficiency with MS Excel
  • 1+ year of customer service experience analyzing and solving customer problems
  • 1+ year of experience working in healthcare  within an office setting
  • 1+ year of experience working with healthcare claims





Assets:


  • Familiar with UHG systems - Safari and FACS preferred

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
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.


Diversity creates a healthier atmosphere: 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.