19 days old

Senior Customer Service Representative - Eden Prairie, MN

Eden Prairie, MN 55344
  • Job Code

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.


Challenge can often be it's own reward. But why settle for just being challenged when you can also be nurtured, mentored and supported as you make an impact in a fast paced career? At UnitedHealthcare, part of the UnitedHealth Group family of businesses, you can have all of the above, everyday. Now, you can take advantage of some of the best training and tools in the world to help serve our existing and new customers. 

As a Senior Customer Service Representative, you'll provide our members with the information they need to make better decisions about their health, helping them get access to the right care the first time. Every day, you'll provide compassionate and empathetic support to 50 to 70 callers providing guidance, support, and resolution for escalated issues. This is no small opportunity. This is where you can bring your compassion for others while building your career. 

This role is equally challenging and rewarding. You'll be on the phone for long periods of time and encounter all types of communication styles and personalities as you help resolve conflicts or issues. You'll deal with stressful situations and resolve complex health care concerns in a positive, simplified manner so that callers fully understand their health care plans and solutions.

Primary Responsibilities:

  • Inbound claims call center handling approximately 45 calls per day in addition to provider emails that spread across 8 different program types and 3 different customer types
  • Handle escalated calls, resolving more complex customer issues
  • Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely and professional manner
  • Help guide and educate customers about the contracts and claims
  • In depth claims research for both physicians and facility claims
  • Understanding of medical billing / payment process from provider billing the claim to its payment by the healthplan
  • Contract interpretation for TRS, MTP, CRS, FS, MIP, EC's for all program types
  • While on the call - determine
    • what the caller is asking
    • what is actually going on with the claim
    • who is responsible for the claim
    • if it's Optum, did we price it?
    • Is the pricing correct?
    • Who is responsible for payment?
    • Did it pay?
    • Did it pay correctly?
    • If no, which of the 15 teams is the best place to assist with or correct the issue
  • Only call scripting is the greeting
  • Documentation scripting exists, but due to the complexity of the calls, agents are often adjusting the scripting to fit the call issue
  • Due to the high number of misdirects it is required for agents to have a wider knowledge of the medical field and programs offered through UHC and Optum to best assist the providers and members

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.



Posted: 2020-06-12 Expires: 2020-07-18

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Senior Customer Service Representative - Eden Prairie, MN

UnitedHealth Group
Eden Prairie, MN 55344

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