Provider Customer Service Representative - Remote in TN (EST hours) - 1035334
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM
The Provider Customer Service Representative will be supporting providers that care for our members. They are responsible for providing responses to questions that may include Benefits and eligibility, Billing and payments, Clinical Authorizations, EOB, and Behavioral health.
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 10:05am – 6:35pm EST. It may be necessary, given the business need, to work some holidays, weekends and / or overtime.
We offer 16 weeks of paid training. The hours during training will be 9:00am to 5:30pm EST, Monday – Friday. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
- Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues
- Quickly and appropriately triage contacts from healthcare professionals (i.e. physician offices, clinics, billing offices)
- Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g. benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health)
- Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls, escalations, and provider dissatisfaction
- Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner
- Strong multitasking to effectively and efficiently navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types
- Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- High School Diploma / GED
- 1+ years of customer service experience analyzing and solving customer’s concerns
- Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
- Ability to work full-time (40 hours/week) Monday – Friday between 10:05am – 6:35pm EST. It may be necessary, given the business need, to work some holidays, weekends, and / or overtime
- Must be 18 years of age or older
- Experience in a related environment (i.e., office, call center, customer service, etc.) using phones and computers as the primary job tools
- Prior health care experience and knowledge of healthcare terminology
- Reside within the state of Tennessee (EST hours)
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
- Ability to remain focused and productive with changing priorities and repetitive tasks
- Ability to multi – task, including the ability to type while talking on the phone
- Ability to resolve calls, avoiding escalated complaints
- Excellent verbal and written communication skills
- Demonstrated problem solving, organization and interpersonal skills
- Demonstrated experience consistently achieving quality and productivity standards
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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.