Customer Service and Claims Representative - Wausau, WI - Full-time / Part-time

Even if you have
no prior experience, we have training classes starting soon to help you build
the successful career that you want - apply today! We provide the support and
structure, you provide the interest and motivation. 

You like working
with people. Even more so, you like helping them. This is your chance to join a
team dedicated to helping our members and their families every day. In this
joint role as a Customer Service and Claims Representative, you'll join
us on a mission to not only deliver the best customer service in the health care
industry, but the best customer service. Period. Your compassion and customer
service expertise combined with our support, training and development will
ensure your success. This is no small opportunity. This is where you can bring
your compassion for others while doing your life's best work. sm


In this role, you
play a critical role in creating a quality experience for the callers that you
connect with and those that you correspond with. Every interaction gives you
that opportunity to improve the lives of our customers and exceed their
expectations. You'll spend the majority of your day by responding to calls from
our members and help answer questions and resolve issues regarding health care
eligibility, claims and payments. You'll also spend a portion of your time
reviewing, researching and processing healthcare claims with the goal to ensure
that every claim has a fair and thorough review.

To learn even more about this position, click here to watch a short video
about the job: http://uhg.hr/CustomerFirstRep  (Note:
these videos are labeled with our internal job title of Customer First
Representatives)

This position is
full-time (40 hours/week) Monday - Friday. Employees are required to have
flexibility to work any of our 8 hour shift schedules during our normal business
hours of (7am to 8pm). It may be necessary, given the business need, to work
occasional overtime or weekends. Our office is located at 115 W Wausau Ave,
Wausau, WI 54401.

Primary
Responsibilities: 
Answer incoming phone calls from customers and identify the
type of assistance the customer needs (i.e. benefit and eligibility, billing and
payments, authorizations for treatment and explanation of benefits
(EOBs)Ask appropriate questions and listen actively to identify
specific questions or issues while documenting required information in computer
systemsOwn problem through to resolution on behalf of the customer in
real time or through comprehensive and timely follow-up with the
memberReview and research incoming healthcare claims from members and
providers(doctors, clinics, etc) by navigating multiple computer systems and
platforms and verifies the data/information necessary for processing (e.g.
pricing, prior authorizations, applicable benefits)Ensure that the proper benefits are applied to each claim by
using the appropriate processes and procedures (e.g. claims processing policies
and procedures, grievance procedures, state mandates, CMS/Medicare guidelines,
benefit plan  documents/certificates)Communicate and collaborate with members and providers to
resolve issues, using clear, simple language to ensure understandingMeet the performance goals established for the position in the
areas of: efficiency, accuracy, quality, member satisfaction and
attendance

Prefer 1 year experience in an office setting,  call center
setting or phone support  role, but not requiredAn education level of at least a high school diploma or GED OR
10 years of equivalent working experienceDemonstrated ability in using computer and Windows PC
applications, which includes strong keyboard and navigation skills and learning
new computer programsAbility to multi-task  duties as well as the ability to
understand multiple products and multiple levels of benefits within each
productAbility to work regularly scheduled shifts within our hours of
operation 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 neededAll new hires will be required to successful complete the
Customer Service  training classes and demonstrate proficiency of the
material
  
There are several
steps in our hiring process - it’s a thorough process because we want to ensure
the best job and culture fit for you and for us. In today’s ultra-competitive
job market, the importance of putting your best foot forward is more important
than ever. And you can start by completing all required sections of your
application. (i.e. profile, history, certifications and application/job
questions). Once you submit your resume, you’ll receive an email with next
steps. This may include a link for an  on-line pre-screening test(s) (or what we
call an assessment) that we ask you to complete as part of our selection
process.  You may also be asked to complete a digital video interview, but we
will offer full instructions and tips to help you. After you have completed all
of these steps, you can check on the status of your application at any time, but
you will also be notified via e-mail. http://uhg.hr/OurApplicationProcess

  

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.SM
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: customer
service representative, customer service, CSR, UnitedHealth Group, call center,
UnitedHealthcare, health care, office, phone support, training
class