Provider Customer Service Call and Chat Representative

UnitedHealth Group; Albuquerque (NM); Remote; USD 40,000 - 70,000; Full time

Benefits offered by this job

Benefits package

Incentive programs

401k & Stock purchase

Job summary

UnitedHealthcare, part of UnitedHealth Group, seeks a Provider Advocate to serve as the primary contact for healthcare providers. You will resolve issues efficiently across calls and chats, navigate multiple systems, and promote self-service tools to improve satisfaction.

This full-time remote role in New Mexico requires strong multitasking, communication, and healthcare process understanding. Training lasts 11 weeks with Arizona-time hours and occasional overtime may apply.

Qualifications

• This role requires a High School Diploma or GED or equivalent work experience.
• Must be 18 years or older and have 1+ years of customer service experience.
• Ability to navigate computer systems and Windows applications.
• Strong multitasking with 40-hour work week and flexible hours within shift window.
• Remote NM residency and adherence to telecommuter policy are required.

Responsibilities

• Serve as the advocate for providers by demonstrating accountability and ownership to resolve issues
• Support providers via calls, chats, and email across multiple channels
• Triage and respond to inquiries from healthcare professionals (physicians, clinics, billing)
• Identify provider needs and resolve questions on benefits, eligibility, billing, authorizations, and explanations of benefits
• Research complex prior authorization and claim issues to prevent repeat calls or escalations
• Collaborate with internal partners to resolve issues and inform providers promptly
• Navigate 30+ systems to extract information and resolve issues across multiple lines of business
• Encourage use of self-service digital tools to speed resolutions

Skills

Multitasking

Time management

Active listening

Written communication

Problem solving

Empathy

Customer service

Education

High school diploma or GED

Tools

Windows PC

Job description

This position is Remote in State of New Mexico. You will have the flexibility to work remotely* as you take on some tough challenges.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

As a Provider Advocate, you'll play a crucial role in the healthcare industry by serving as the primary point of contact for healthcare providers. Your responsibilities include resolving issues efficiently, often on the first call, and providing support through various channels like calls and chats. You'll need to navigate multiple systems, collaborate with internal partners, and promote self-service digital tools to enhance provider satisfaction. Success in this role is measured by metrics such as first call resolution rate, provider satisfaction scores, and efficient issue resolution time. This dynamic position requires excellent multitasking, effective communication, and a deep understanding of healthcare processes.

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 8:35 am - 5:05 pm MST. It may be necessary, given the business need, to work occasional overtime, weekends, and / OR some holidays.

We offer 11 weeks of paid training. The hours during training will be 8:00 am - 4:30 pm Arizona Time from Monday - Friday (subject to change based on trainer availability). Training will be conducted virtually from your home. 100% attendance is a must during training period.

Primary Responsibilities:

• Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues


• Service Providers in a multi-channel environment including call, dual chats, and email as required.


• Quickly and appropriately triage, contacts from healthcare professionals (i.e. physician offices, clinics, billing offices)


• Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g. benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health)


• Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls/messages, escalations, and provider dissatisfaction


• Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner


• Strong multitasking to effectively and efficiently navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types


• Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution

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.

Required Qualifications:

• High School Diploma / GED OR equivalent work experience


• Must be 18 years of age OR older


• 1+ years of customer service experience analyzing and solving customer's concerns


• Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications


• This position involves handling provider calls or concurrent chats, with an expected volume of 50 - 70 calls/chats daily. It requires full attention to work duties. Employees in this role must ensure they have uninterrupted work time during their shifts, except for scheduled breaks and lunch periods


• Available to work full-time (40 hours/week) Monday - Friday for any hours between 8:35 am - 5:05 pm MST. It may be necessary, given the business need, to work some holidays, weekends, and/or overtime as business needs require.

Preferred Qualifications:

• Experience in a related environment (i.e., office, call center, customer service, etc.) using phones and computers as the primary job tools


• Health care experience and knowledge of healthcare terminology

Telecommuting Requirements:

• Reside within State of New Mexico.


• Ability to keep all company sensitive documents secure (if applicable)


• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.


• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service (UHG requires a wired internet connection: cable, DSL or fiber internet service with Minimum speed standard of 25 Mb download/5 Mb upload. Wireless services such as satellite, hot spot, line of sight antenna cannot be used for telecommuting.)

Soft Skills:

• Proficient in multi-tasking, including managing multiple conversations simultaneously.


• Skilled in quickly resolving calls and messages, effectively preventing escalated complaints.


• Strong time management skills.


• High emotional intelligence and empathy.


• Excellent active listening and comprehension abilities.


• Exceptional written communication skills.


• Demonstrated problem-solving, organizational, and interpersonal skills.


• Proven track record of consistently achieving quality and productivity standards.


• Typing Speed greater than or equal to 35-40 WPM with accuracy of 90%

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we comply with all minimum wage laws as applicable.

• a comprehensive benefits package


• incentive and recognition programs


• equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.