4 days old

Provider Inquiry Call Center Representative - San Juan, PR

Blanding, UT 84511
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  • Job Code
    876347

The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll help understand and overcome errors in claims processing. You'll have all the tools and backing you need to help manage subrogation files, negotiate settlements and ensure adherence to compliance policies. All the while, you'll be building your career with a leader and reaching for the highest levels of performance as you do your life's best work.(sm) 


When you are in the business of health care, you're in the business of people. At UnitedHealth Group we want every customer experience to be distinctly personal. The challenge is complex. When people call us for help, their focus is on getting the best care possible. We help them understand their benefits and their options. This part of their lives matters a lot to them and it matters just as much to us. Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.

As Provider Inquiry Call Center Representative you will be accepting and directing all incoming phone calls according to policy and procedures and department productivity and quality standards. Resolves routine to moderately complex issues, refers appropriately to Team Lead and/or Supervisor as needed. 


Primary Responsibilities:

  • Answer in-coming calls from the Provider Inquiry Line and the Fraud Hotline. Incoming calls can be from Providers questioning claim status, review status, appeal status and/or reporting of fraud
  • Logging of all in - coming calls in a Call Tracking Documentation System
  • Maintains accuracy standards of 99% or greater
  • Maintains adherence standards of 95% or greater
  • Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
  • Works independently and as part of a team
  • Act as a resource for others
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: 2020-05-22 Expires: 2020-06-21

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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Provider Inquiry Call Center Representative - San Juan, PR

UnitedHealth Group
Blanding, UT 84511

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