29 days old

Senior Customer Service Representative - San Antonio, Texas

San Antonio, TX 78205
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  • Job Code
    893847
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Challenge can often be its 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.

The Sr. Customer Service Representative provides service to providers who have claims related questions by promptly responding to their concerns in a timely manner.  This position will assist in resolving payment/adjudication questions or concerns by insuring issues are presented to the appropriate department for resolution and/or will resolve payment/adjudication questions at the time the call is received; explaining calculation methodology, contract terms, procedures, etc on a limited basis.

Primary Responsibilities:
  • Clearly communicates claims status, payment or non-payment information related to claim in question by the customer
  • Informs and assists callers with the claims appeals process, if necessary
  • Enters detailed information into a tracking system to ensure that all priority issues are handled within established time frames and proactively notifies caller of the expected time frame for resolution
  • Answer customer service lines promptly and professionally and maintain at least a 95% response time
  • Maintains quality standards as required for position
  • Demonstrates excellent customer service by determining the reason for the call, acknowledging the callers concerns and resolve concerns and/or explain action to be taken within the expected time line for resolution
  • Presents a pleasant voice to all callers regardless of the stressful nature of the situation
  • Performs all other related duties as assigned

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: 2020-09-29 Expires: 2020-11-28

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 - San Antonio, Texas

UnitedHealth Group
San Antonio, TX 78205

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