Provider Customer Service Call and Chat Representative

This position is Remote within the state of North Carolina. You will have the flexibility to work remotely* as you take on some tough challenges.

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 to start Caring. Connecting. Growing together.

As a Provider Advocate, you’ll play a crucial role in the healthcare industry by serving as the primary point of contact for healthcare providers. Your responsibilities include resolving issues efficiently, often on the first call, and providing support through various channels like calls and chats. You’ll need to navigate multiple systems, collaborate with internal partners, and promote self-service digital tools to enhance provider satisfaction. Success in this role is measured by metrics such as first call resolution rate, provider satisfaction scores, and efficient issue resolution time. This dynamic position requires excellent multitasking, effective communication, and a deep understanding of healthcare processes.

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 9:35am-6:05 PM EST. It may be necessary, given the business need, to work occasional overtime, weekends, and / OR some holidays.

We offer 11 weeks of paid training. The hours during training will be 8am-4:30pm EST from Monday – Friday (subject to change based on trainer availability). Training will be conducted virtually from your home. 100% attendance is a must during training period.

Primary Responsibilities:

• Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues
• Service Providers in a multi-channel environment including call, dual chats, and email as required
• 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/messages, 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.

Required Qualifications:

• High School Diploma / GED or equivalent work experience
• Must be 18 years of age OR Older
• 1+ years of experience in Customer Service 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
• This position involves handling provider calls or concurrent chats, with an expected volume of 50 – 70 calls/chats daily. It requires full attention to work duties. Employees in this role must ensure they have uninterrupted work time during their shifts, except for scheduled breaks and lunch periods
• Ability to work any of our 8-hour shift schedules during our normal business hours of 9:35am-6:05 PM EST. It may be necessary, given the business need, to work occasional overtime, weekends, and / OR some holidays

Preferred Qualifications:

• Experience in a related environment (i.e., office, call center, customer service, etc.) using phones and computers as the primary job tools
• Health Care experience and knowledge of healthcare terminology
• Presently employed within UHC Operations & Experience. (Also known as UHC Benefit Operations. Use Sparq to confirm your alignment in 3 quick steps: 1) From the Sparq Homepage, click “My Profile”. 2) Click “Organization Chart”. 3) Look upward on the org chart to confirm that you report through Mike Baker)

Telecommuting Requirements:

• Reside within the state of North Carolina
• 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

Soft Skills:

• Proficient in multi-tasking, including managing multiple conversations simultaneously
• Skilled in quickly resolving calls and messages, effectively preventing escalated complaints
• Strong time management skills
• High emotional intelligence and empathy
• Excellent active listening and comprehension abilities
• Exceptional written communication skills
• Demonstrated problem-solving, organizational, and interpersonal skills
• Proven track record of consistently achieving quality and productivity standards
• Typing Speed greater than or equal to 35-40 WPM with accuracy of 90%

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 – $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

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