Customer Service Representative - Healthcare Financial Protection

Role Overview

We are seeking a Customer Service Representative within the healthcare financial protection sector to assist members by providing essential information to help them make informed decisions about their health. This remote full-time position involves managing 50 to 70 incoming calls daily with empathy, compassion, and professionalism, guiding members towards appropriate care and resolving their concerns effectively.

Primary Duties

• Handle sensitive calls diplomatically while maintaining professionalism.
• Actively listen to understand caller perspectives.
• Identify and pursue solutions proactively to address customer service issues.
• Document, confirm, and resolve or route member, broker, and customer inquiries to the suitable internal departments.
• Respond to inbound phone calls, emails, or written inquiries regarding eligibility, benefits, claims status, procedures, reimbursements, claim filing, and appeals or grievances.
• Utilize internal resources for warm transfers to appropriate departments.
• Meet or surpass standards for accessibility, responsiveness, and quality of service delivery.
• Manage inquiry caseload independently to ensure timely, effective outcomes.
• Contribute to high satisfaction levels by responding promptly and utilizing strong communication and analytical problem-solving skills.

Required Qualifications

• High School Diploma, GED, or equivalent work experience.
• Minimum age of 18 years.
• At least one year of experience in customer service.
• Availability to work full-time Monday through Friday with flexible shifts between 7:00 AM and 7:00 PM CST, including occasional overtime as needed.

Preferred Qualifications

• Two or more years of experience in healthcare, preferably in a service-related role.
• One or more years of call center experience.
• Data entry skills.
• Familiarity with OnBase and LeaveSource systems.
• Proficiency in Microsoft Office applications.

Telecommuting Requirements

• Maintain security and confidentiality of company documents.
• Have a dedicated workspace separated from living areas to ensure privacy.
• Reside in an area with access to UnitedHealth Group-approved high-speed internet or equivalent.

Soft Skills

• Strong understanding of various products such as FMLA, Life Insurance, Accident, and Critical Illness benefits.
• Effective problem-solving and project management capabilities.
• Excellent oral and written interpersonal communication skills.
• Strong organizational abilities and customer communication proficiency.