1+ months

Agent Complaint Tracking Analyst - Minnetonka, MN - 917985

Minnetonka, MN 55345 Work Remotely
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  • Job Code
    917985

This role is temporarily remote. Training is conducted virtual from your home. This role is an onsite role and you will transition once training is completed to work in the office in the future.

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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

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TheAgent Complaint Tracking Analystwill receive agent complaints from the Centers for Medicare and Medicaid Services (CMS), regulatory or UHC internal sources. Responsibilities include upload and set up of agent complaint records within a database; analyzing agent complaints for validity; analyzing the complaint in order to assign the correct complaint allegation(s); and utilization of multiple internal resource tools to recommend a proper disposition of complaints. Assigns corrective actions within a case management tool, utilizing documented hierarchies. Utilizes pertinent investigation data and uses own judgment as well as decision job aids to perform audits of all completed corrective actions to determine proper outcome. Utilizes reporting to follow up on overdue corrective actions. Performs calls to UHC members who had enrolled via public web portal, utilizing approved script.

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Primary Responsibilities:

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  • Monitor completion of Complaint Education Contact (CEC) and Corrective Action Response (CAR) outreach coaching requests, and escalate incomplete assignments
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  • Analyze/audit coaching request coaching notes (notes document the agents required training after corrective action has been assigned following a complaints investigation) for quality and provide feedback for improvement.
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  • Manage the receipt and disposition of sales event agent infractions
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  • Manage the receipt and disposition of secret shopper agent infractions
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  • Utilizes an approved script to call members who have enrolled via UHCs public web portal, to determine compliant application processes. Records findings within a case management tool
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  • Acts as backup for the Agent Compliance Tracking Consultant, or Department of Insurance Consultant
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  • Assist with the creation of CMS requested agent files
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  • Subject Matter Expert - Acts as a resource for others with less experience
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  • Receive, triage, process, and decision incoming agent complaints to determine ultimate disposition of those complaints
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  • Respond to CMS requests for information around agent complaints
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  • Assists with responses to State Departments of Insurance (DOI) requests for information around agent complaints
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  • Perform other related duties as required to achieve the goals and objectives of the company and department
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Youll 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.

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Required Qualifications:

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  • High School Diploma / GED (or higher)
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  • 1+ years of experience in the healthcare, insurance, or financial services industry
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  • 6+ months of experience working in a regulated industry
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  • 6+ months of telephonic customer service experience
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  • 6+ months of auditing or second level review experience
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  • 1+ years of experience working with Medicare and Retirement (M&R) plans, summaries of benefits and explanation of coverage as it relates to M&R insurance plans
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  • Experience handling or working with confidential or company sensitive data
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  • Work experience using Microsoft Outlook (calendaring, emailing, folders, attachments)
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  • Work experience using Microsoft Excel (creating, editing, saving, filtering, sorting spreadsheets)
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  • Work experience using Microsoft Word (creating, editing, saving documents)
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  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
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  • Ability to keep all company sensitive documents secure (if applicable)
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  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.
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Preferred Qualifications:

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  • Associate's degree (or higher)
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  • Experience working with multiple system platforms
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  • Knowledge of insurance industry, compliance, licensing or claims experience
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  • Knowledge of GPS, iLead, bConnected, ODM, ICM, SMRT, PCL, ImageRight, OnBase, and Learning Lab
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  • Experience working with Centers for Medicare and Medicaid Services (CMS) Guidelines
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Soft Skills:

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  • Strong communication, and interpersonal skills; able to work with team members and all levels within the organization.
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  • Strong analytical/problem solving skills
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  • Able to work independently, with minimal supervision: self-starter
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  • Hard work, honesty, integrity and unwavering business ethics
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  • Ability to multi-task and balance own workload
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UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

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Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in healthcare. And we are the largest business in the nation dedicated to serving their unique health and well - being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our Healthcare system. Ready? It's time to do your lifes best work.SM

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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.

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

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Keywords: UnitedHealth Group, Complaint Tracking Analyst, Minnetonka, MN, CMS, regulated industries, M&R, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #rpo

Posted: 2021-04-15 Expires: 2021-07-02

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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Agent Complaint Tracking Analyst - Minnetonka, MN - 917985

UnitedHealth Group
Minnetonka, MN 55345

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