Customer Service Rep. - Golden Valley, MN

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.

United Behavioral Health, a UnitedHealth Group company, is a leading provider of emotional wellness services. Currently serving over 22 million Americans, our innovative solutions include behavioral health, employee assistance, work/life and pharmacy management services, as well as a unique disability support program. We offer specialized, confidential support to help our members live and work well, and excellent resources and rewards for your career so you can do the same. A healthy business awaits you at UBH.



Job Description:

Respond to, document, investigate and resolve customer calls regarding claims payments, benefits, eligibility and certification.



Job Responsibilities:
Accountable for problem resolution of customer issues and communicate resolution to appropriate parties.
Available, as scheduled, to respond to calls from customers regarding claims payments, benefits, eligibility and certification issues.
Investigate issues and document steps taken to achieve resolution.
Manage resolution of issues through contact with UBH claims dept., case mgmt and external payers ultimately achieving a positive outcome.
Investigate and handle retro-certification activities, as required for resolution of customer issues.
Respond to customers regarding status of formal complaints or appeals.


Escalate issues to Senior Customer Service Reps when appropriate.


Meet departmental standards for production and quality.


Meet departmental standards for schedule adherence.


Participate in training and self-development opportunities when appropriate.


Demonstrate a cooperative, positive attitude in the workplace.


Demonstrate a basic knowledge of managed healthcare and claims.


Perform all other duties as deemed appropriate to provide customer service.




Job Requirements:

Job Qualifications:


1-2 years in managed healthcare and claim resolution strongly preferred.


1-2 years of customer service experience, preferably in a high-volume call center environment.


PC proficiency in MS Windows and Word required with call center software strongly preferred.


Demonstrated strengths in listening, problem solving, organization and prioritizing.


AA degree preferred.


Accurate typing skills.


Display high level of confidence when responding to phone inquiries.


Basic knowledge of English for reading, writing and mathematical skills, generally equivalent to a high school diploma.


Previous experience as a Customer Service Representative required.


Strong verbal communications skills are required.


Proven ability to handle all eligibility related inquiries with ease.


Exhibit advanced job knowledge and quality customer service skills.


Some overtime is required in order to meet scheduled deadlines.

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