Remote Customer Service Advocate Jobs

Manage multiple dispute cases simultaneously in an efficient and effective manner in accordance with standard operating procedures

Minimum 2 years experience in Customer Service delivery roles with specific Escalations / Complaints experience

You champion the customer experience and can quickly form relationships and establish trust, respect, competence and confidence with our customers

Experience in service delivery in an Omnichannel environment and strong digital experience (Email, messaging and social media channels)

Excellent written and verbal communication skills

Paid Life insurance, AD&D, and disability benefits

Must have knowledge of basic spreadsheet, word processing, and data entry skills.

Must have strong organizational skills and be able to effectively manage and prioritize tasks.

High School Diploma or the equivalent plus a minimum of one year medical terminology or medical services experience required.

Must be proficient and comfortable in a computer based environment. Experience in a call center environment preferred.

Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.

Advancement opportunities, professional skills training, and tuition Reimbursement

Responds to, research and/or assists with priority inquiries and special projects as required by management.

Provides feedback to management regarding customer problems, questions and needs.

Maintains accurate records on complaints and/or other customer comments and makes recommendations for changes to management.

Follows through on complaints until resolved or reports to management as needed.

Maintains basic knowledge of quality work instructions and company policies.

1 year of claims processing or customer service experience OR bachelor's degree in lieu of work experience.

We promote from within our diverse workforce regularly and offer regular opportunities to learn and grow

High school diploma or equivalent, additional customer service experience or training, required

Desire to increase knowledge, learn new systems and adopt new tools to enhance overall job performance

Benefits for the Client Advocate:

Qualifications for the Client Advocate:

Free Short-Term & Long-Term Disability insurance

Good verbal and written communication skills

Good spelling, punctuation, and grammar skills

Identify incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines

Examine and process claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines

Enter claims into the claim system after verification of correct coding of procedures and diagnosis codes

Ensure claims are processing according to established quality and production standards

Respond to, research and/or assist with priority inquiries and special projects as required by management

Provide feedback to management regarding customer problems, questions and needs

Maintain accurate records on complaints and/or other customer comments, and makes recommendations for changes to management

Follow through on complaints until resolved or reports to management as needed

Maintain basic knowledge of quality work instructions and company policies

1 year of claims processing or customer service experience OR Bachelor's Degree in lieu of work experience

Excellent verbal and written communication skills.

Strong human relations and organizational skills.

2 years-of customer service or call center experience.

Knowledge of word processing, spreadsheet, and database software.

Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk-in inquiries. Accurately documents inquiries.

Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments.

Assists in project management of the social needs and health equity initiatives

Support organizational DEI change readiness and management efforts

Plans, coordinates and reports on health promotion and wellness education outreach activities for the UnitedHealthcare Community and State plan in Tennessee

Participates in continued education in social responsibility, social determinants, and all other necessary education

Bachelors degree in healthcare, public health, social work, or similar field or equivalent experience in health care or social work

4+ years of experience in a deadline driven environment

Continuing education funds for additional certifications and certification renewal

401(k) retirement savings plan with company match

Subsidized health plans and free vision coverage

Paid annual leave – the longer you work here, the more you earn

On-site cafeterias and fitness centers in major locations

Wellness programs and healthy lifestyle premium discount

Sales or account management experience

3+ years of combined education, work and/or volunteer experience

Utilize time and resources effectively to achieve performance targets centered around a positive member experience

Participate in continuous learning and training sessions, developing new skillsets

High School Diploma / GED (or higher) OR equivalent work experience

Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)

Document and manage cases within applicable systems by reviewing, updating, and closing daily

Bachelor’s degree preferred or 4 years equitable business experience required

1-2 years of multi-channel customer service experience

1-2 years of prior customer facing HCM or Paycor experience is a plus

Proven excellence in customer service and relationship building skills required

Effective organizational skills proven in a fast-paced, service-oriented position

Insurance, benefits, claims or medical/healthcare experience a plus, but not required.

Prior customer service experience working in a call center or in a position that entails handling calls is required.

Excellent communication skills necessary to be successful.

Please note that this position will be fully remote and open to those living within the U.S.

Handling call volumes averaging 30/calls per day and will be documenting all inquiries using our internal systems.

Working with your support team to appropriately refer unresolved inquiries or escalated calls based on customer service procedures and guidelines.

Meeting monthly service objectives as outlined by management

Essential Job Duties & Responsibilities

Offering prayer to all members and providers at every appropriate opportunity

Two (2) years customer service experience in a medical, dental, optical or related setting required

Two years high volume contact center experience preferred

Strong knowledge of computer hardware and software

5 years-of experience processing and adjudicating claims.

Knowledge of mathematical and statistical concepts.

Proficient in word processing and spreadsheet applications. proficient database software skills.

Preferred Software And Other Tools

We Prefer That You Have

Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient certification and/or prior authorization requests.

Initiates and manages clinical referrals for members.

What are your key responsibilities?

Acts as a liaison between hospitals, physicians, health plans, vendors, patients, or referral sources.

Verifies and obtains authorizations if needed. Enters referrals and documents communications, actions, and other data in departmental systems.

Refers cases requiring clinical review to appropriate clinical professionals.

Our Federal Way Branch is three blocks from the transit center.

We are a not-for-profit organization focused on giving back to our members.

We are a stable organization that is well capitalized and growing.

With just under 150 employees, we are small enough to connect personally and big enough to create a dynamic work environment.

Eleven paid federal holidays off.

Set, dependable hours with no Saturday shifts!

Sales or account management experience

New York residents' salary range is $16.00 - $31.44, based on factors such as education, work experience, and certifications

3+ years of combined education, work, and/or volunteer experience

Respond to and resolve customer service inquiries and issues related to benefits, eligibility, claims, and financial spending accounts

High School Diploma / GED or equivalent work experience

Familiarity with medical terminology, health plan documents, or benefit plan design in a healthcare/insurance environment

Sales or account management experience

Minimum of 3+ years of combined education, work and/or volunteer experience

High School Diploma / GED (or higher) OR equivalent work experience

Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)

All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Assist customers in navigating myuhc.com and other UnitedHealth Group websites and encourage and reassure them to become self-sufficient

Experience with Vendor Management Systems, Digital Marketing, E-Commerce, and Merchandising.

10% System Knowledge - Builds system knowledge and expertise through ongoing tailored, training classes.

This Position typically reports to Manager, Brand Advocate

Experience with SQL, Tableau and Adobe products.

Manages multiple projects with competing priorities.

Strong written and oral communication skills.

Demonstrated organizational and communication skills required

Intermediate typing skills – 50 WPM strongly desired

Deep problem solving skills with demonstrated ownership of issue resolution

Possess top-notch people skills – listening, caring, connecting, empathy, and supporting

Strong skillset in the use of the suite of Microsoft Office tools strongly desired

Ability to multi-task, prioritize and effectively adapt to a fast paced changing environment required