Customer Advocate - Las Vegas, NV

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

At UnitedHealth Group, we are a healthy business in more ways than one. We are a Fortune 100 company identified as the first or second most admired company in the health care industry by rankings published in Fortune magazine since 1995. We also have the privilege each day - directly or indirectly - to make a significant difference in someone's life. Sound like a rare combination? It is. Join us and you'll be inspired to discover your own mix of professional advantages and personal rewards.



Job Description:

Serve as liaison to address, respond, and resolve escalated issues with external and internal customers. Support the overall delivery of benefits and services within production and service teams by providing support to existing and potential customers.



Responsibilities:


Active participant in enrollment meetings, health fairs and on-site customer visits.


Complete special projects, (i.e. research & resolution).


Serve as liaison between internal customers (Customer Service, Claims, Account Management, Quality Management & Professional Relations) to facilitate resolution of non-clinical complaints/grievances and respond to inquiries.


Work with Dental Directors to manage their monthly claim review and on-call schedules.


Work with Claims Dept. to provide claim review time necessary to maintain department turn-around-time requirements.


Maintain Peer Review Facility and Chart Audit database for contracted provider offices.


Administrate the scheduling, coordination and preparation of audits to be performed.


Facilitate submission of conducted audits to Quality Management.


Schedule and coordinate local committee meetings.


Collect submitted credentialing forms for review to ensure they are complete and that necessary documents are attached.


Forward to Credentialing Department, maintain database of forms submitted, collect outstanding information necessary to complete credentialing process.


Liaison to Credentialing Department for status inquiries.


Monitor and coordinate network issues with Professional Network Relations and general support for Professional Relations Department.


Job Requirements:

Requirements:
Ability to handle multiple tasks in a fast-paced environment.
Excellent:
analytic and organizational skills and attention to detail.
oral and written skills.
interpersonal skills.
Ability to travel for customer/client meetings.
Proven customer service skills.
Solid presentation and writing skills.
Professional.
Problem solving ability.
Knowledge of:
dental health insurance industry (products and services) and the managed care environment.
dental terminology, referral and pre-authorization processes.
Claim knowledge helpful.
Dental practice management experience a plus.
Strong computer skills including MS Office Applications (word processing, database management and spreadsheet applications).
Bi-lingual preferred.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V