Provider Customer Service Representative – National Remote

By | September 12, 2022

Job Responsibilities : Provider Customer Service Representative – National Remote

Salary : $16.00 – $26.88 an hour

Company : UnitedHealthcare

Location : Remote US

Educational requirements : High School

$1500 Sign-On Bonus for External Candidates

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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 . SM

Provider Service contact center advocates support the millions of providers who care for our 50 million members. The responsibilities completed by provider service advocates reduces downstream follow-up and research members. This in turn reduces downstream workloads for other service organizations supporting members across the enterprise.

PSO contact center advocates serve healthcare professionals who are fluent in healthcare terminology often with many years of experience across multiple payers. These healthcare professionals expect to receive timely confident and thorough responses to questions that span the full continuum of care delivered to a member including but not limited to:

  • Benefits and eligibility
  • Billing and payments
  • Clinical authorizations
  • Explanation of benefits
  • Behavioral health.

Meeting this expectation requires PSO contact center advocates to possess a deep knowledge of UnitedHealthcare’s products procedures and billing practices to ensure that the provider receives an excellent experience during their encounter. New contact center advocates complete extensive new-hire training over a 12–13-week period and ongoing education to ensure their thorough preparedness to meet and exceed provider expectations for each call encounter.

This position is full-time Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00AM – 6:00PM. It may be necessary given the business need to work occasional overtime.

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

Primary Responsibilities:

  • 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

Phone Support and Provider Issue Resolution

  • 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
  • Ask appropriate questions and listen actively to identify underlying questions/issues (e.g. root cause analysis)
  • Gather appropriate data/information and perform initial investigation to determine scope and depth of question/issue
  • Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner
  • Meet performance goals established for the position optimizing provider satisfaction first call resolution and attendance
  • Learning new skills will be required over time in this role as the function evolves and business needs change

Provider Experience and Service Excellence

  • Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues
  • Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution
  • Meet performance goals established for the position optimizing provider satisfaction first call resolution and attendance
  • Maintain ongoing communications with callers during the resolution process to communicate status updates and other required information
  • Maintain focus on provider interactions without being distracted by other factors
  • Identify inaccurate/inconsistent information found in systems/tools and communicate to appropriate resources

Business Acumen and Industry Knowledge

  • Possess a deep knowledge of UnitedHealthcare’s products procedures and billing practices to ensure that the provider receives an excellent experience during their encounter
  • Demonstrate knowledge of applicable health care terminology
  • Maintain knowledge of information/process changes due to healthcare industry changes (e.g. regulatory/governmental reforms innovations process improvements)
  • Ensure compliance with applicable legal/regulatory requirements (e.g. HIPAA state/regional requirements)

Continuous Learning

  • Learn new skills as the function evolves and business needs change
  • Demonstrate knowledge of established workflows and support processes
  • Review/analyze phone support data/metrics and communicate patterns/trends to internal stakeholders as needed (e.g. leadership Subject Matter Experts business partners)
  • Provide training/mentoring to other team members as needed (e.g. new-hires refresher training)

Provider Service Operations – A day in the life – United Healthcare Enterprise Video On Demand (uhc.com)

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 higher)
  • 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 8:00am – 8:00pm. It may be necessary given the business need to work some holidays weekends and or overtime as business needs require

Preferred Qualifications:

  • 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

Telecommuting Requirements:

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • 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:

  • 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.

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills experience and dedication that serving in the military demands. In fact many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity Compassion Relationships Innovation and Performance. Whether you are looking to transition from active duty to a civilian career or are an experienced veteran or spouse we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa a Senior Quality Analyst works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

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

Colorado Connecticut or Nevada Residents Only: The salary range for Colorado residents is $16.00 – $26.88. The salary range for Connecticut / Nevada residents is $16.83 – $29.66. Pay is based on several factors including but not limited to education work experience certifications etc. In addition to your salary UnitedHealth Group offers 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 UnitedHealth Group you’ll find a far-reaching choice of benefits and incentives

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group UnitedHealthcare or related entity in a full time part time or per diem basis (Internal Candidates) are not eligible to receive a sign on bonus.

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.

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