1+ months

Customer Service and Claims Representative - Wausau, WI

Wausau, WI 54403
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  • Job Code
    892878

Even if you have no prior experience, we have training classes starting soon to help you build the successful career that you want - apply today! We provide the support and structure, you provide the interest and motivation.

 

You like working with people. Even more so, you like helping them. This is your chance to join a team dedicated to helping our members and their families every day. In this joint role as a Customer Service and Claims Representative, you'll join us on a mission to not only deliver the best customer service in the health care industry, but the best customer service. Period. Your compassion and customer service expertise combined with our support, training and development will ensure your success. This is no small opportunity. This is where you can bring your compassion for others while doing your life's best work. SM

 

In this role, you play a critical role in creating a quality experience for the callers that you connect with and those that you correspond with. Every interaction gives you that opportunity to improve the lives of our customers and exceed their expectations. You'll spend the majority of your day by responding to calls from our members and help answer questions and resolve issues regarding health care eligibility, claims and payments. You'll also spend a portion of your time reviewing, researching and processing healthcare claims with the goal to ensure that every claim has a fair and thorough review.

 

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 7:00 am to 8pm. It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located at 115 W Wausau Ave, Wausau, WI 54401.

 

Primary Responsibilities:

  • Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
  • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
  • Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
  • Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
  • Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan
  • documents/certificates)
  • Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
  • Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance

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.
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Posted: 2020-09-25 Expires: 2020-11-08

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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Customer Service and Claims Representative - Wausau, WI

UnitedHealth Group
Wausau, WI 54403

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