Position Description: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.The purpose of this role is to interact with members regarding medical and pharmacy benefits, eligibility & claims issues and to assist with plan selection and enrollment. This role is expected to identify opportunities to connect members to the best resources to meet their healthcare needs and provide support in order to resolve medical and benefits issues on behalf of a member. The Customer Service Advocate builds trust with members across their health care lifecycle.Primary Responsibilities:Provide in language service to Mandarin, Cantonese, and English speaking customers over the phoneOwn problem through to resolution on behalf of the member in real time or through comprehensive and timely follow - up with the memberEffectively refers and enrolls members to appropriate internal specialists and programs, based on member's needs and eligibilityRespond to and resolve on the first call, 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.Resolve member service inquiries related to:Medical benefits, eligibility and claimsTerminology and plan designFinancial spending accountsPharmacy benefits, eligibility and claimsCorrespondence requestsEducate members about the fundamentals of health care benefits including:Managing health and well beingMaximizing the value of their health plan benefitsSelecting the best health plan to meet their health needsChoosing a quality care provider and appointment schedulingPremium provider education and steeragePre - authorization and pre - determination requests and statusAssist members in appointment scheduling to proactively address gaps in careIntervene with care on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when neededResearch complex issues across multiple databases and work with support resources to own the resolution of all customer issues and anticipate their future healthcare needs or potential opportunities to improve the experienceProvide education and status on previously submitted pre - authorizations or pre - determination requestsMeet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendanceMaximizes use of community services, support programs, and resources available to members
Requirements:High School Diploma / GED or higher Bilingual fluency (verbal and written) in Chinese (both Cantonese and Mandarin) and English1+ years in a Customer Service environment; Proven customer service skills and experience working in retail, call centers, or any other professional settingUpon hire you must successful completion of UnitedHealthcare Operations new hire training and demonstrated proficiency required. This role will also be required to successful complete the UnitedHealthcare Operations Customer Service Advocate training classes and demonstrate proficiency of the materialAbility to work regularly scheduled shifts within our hours of operation (Monday to Friday 9:00 AM to 8:30 PM EST), where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work overtime and / or weekends, as neededAssets:Associate's Degree (or higher)Experience in Health Care / Insurance environment - Familiarity with medical terminology, health plan documents, or benefit plan designPrevious experience in translating healthcare - related jargon and complex processes into simple, step - by - step instructions customers can understand and act upon Soft Skills:Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner and delivering on commitments)Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the memberAbility to overcome objections and persuade members to take action / change behaviorAbility to utilize multiple systems / platforms while on a call with a member – strong computer skills and technical aptitudeProficient problem solving approach to quickly assess current state and formulate recommendationsFlexibility to customize approach to meet all types of member communication styles and personalitiesExcellent conflict management skills including: Professionally and adeptly resolve issues while under stressDiffuse conflict and member distressDemonstrate personal resilienceStrong verbal and written communication skills. Solid time management skillsStrong attention to detail Physical Requirements and Work Environment:Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computerCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 where ever 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.SMDiversity 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: UHG, UHC, customer service, Chinese, Mandarin, Cantonese, bilingual, service advocate
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.