Complex Customer Care Representative Job Opening

Complex Customer Care Representative

UnitedHealth Group

Wausau, Wisconsin
Category: Financial Advisor

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.

You like working with people. Even more so, you like helping them. When you join us as a Complex Customer Care Representative for UnitedHealthcare, you’ll have the opportunity to make a difference in the lives of our members and their families each day as they look to you as their trusted advisor and advocate. You’ll be empowered to compassionately deliver an exceptional experience - always remembering that there is a real person on the other end of the phone who is looking for help, guidance, and support. You’ll help them understand and make informed decisions about their care services by assisting them with their needs from start to finish. You will answer their questions, and may resolve outstanding issues, schedule appointments, or help them to enroll in and / or select a health care plan. Here, you’ll join us on a mission to deliver the best customer service in the health care industry. 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


Primary Responsibilities:


  • Provide an exceptional customer service experience when responding to and resolving customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
  • Research complex issues (such as Medical, Dental, Flex Spending, Pharmacy, etc.) across multiple databases and work with support resources to resolve customer issues and / or partner with others to resolve escalated issues
  • Own issue through to resolution on behalf of the member in real time or through comprehensive and timely follow - up with the member
  • Apply creative solutions and effective problem - solving techniques to address members’ needs
  • Educate the member on health incentives offered by their employer as well as consumer driven health products; HSA, HRA, and HDHP - some resulting in additional healthcare dollars for the member to utilize
  • Educate the caller on the benefits of a primary care physician and help to ensure / educate that all preventive screenings have been completed
  • Intervene with care providers (doctor’s offices) on behalf of the member to assist with appointment scheduling or other matters when needed
  • Address complex issues with an awareness of when to refer complicated situations to various departments or leadership for further assistance
  • Translate healthcare - related terms or terminology and complex processes into simple, step - by - step instructions which members can understand

Required Qualifications:
  • High School Diploma / GED (or higher)
  • Customer service experience in an office or professional setting
  • Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer program
  • Ability 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 as needed
  • All new hires will be required to successfully complete the training classes and demonstrate proficiency of the material
Preferred Qualifications:
  • Familiarity with medical terminology, health plan documents, or benefit plan design preferred
  • Prior experience utilizing multiple systems / platforms while on a call with a member preferred
Soft skills
  • Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in a respectful, timely manner, consistently meeting commitments)
  • Flexibility to customize approach to meet all types of member communication styles and personalities
  • Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
  • Proficient problem - solving approach to quickly assess current state and formulate recommendations
  • Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrate personal resilience
  • Ability to multi - task as well as the ability to understand multiple products and multiple levels of benefits within each product
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do 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