Client Services Account Specialist

This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Client Services Account Specialist, is a key client-facing role, responsible for supporting payer clients in the end-to-end understanding, processing, and resolution of complex specialty claims. This position acts as the primary liaison between claims payors and providers, ensuring compliance with our network contractual agreements and that both parties receive timely, accurate, and comprehensive service. 

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 7am – 6pm CST. It may be necessary, given the business need, to work occasional overtime.

This will be on the job training and the hours during training will be aligned with your schedule.

                                                 

Primary Responsibilities:

• Serves as the primary claims point of contact for assigned payer clients accessing Whole Health Solutions products, including transplant, oncology, congenital heart disease, and dialysis, maintaining strong relationships and ensuring client satisfaction
• Provide expert guidance on the interpretation of repriced claims data, payment methodologies, and contract terms
• Coordinates across internal teams (network, claims operations, account management, etc.) to resolve complex claims issues and delivery timely response to client inquiries
• Supports client onboarding and training to ensure a thorough understanding of claims operational procedures and service expectations, one-on-one and in large group trainings
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the client
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
• Assist clients in navigating UHG websites or applications utilizing remote desktop system capabilities
• Other 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.

Required Qualifications:

• High School Diploma / GED or equivalent years of work experience
• Must be 18 years of age or older
• 2+ years of customer service experience analyzing and solving customer problems in the healthcare insurance/and or medical industry
• Intermediate level of proficiency with Microsoft Office including Microsoft Word (create correspondence and work within templates), Microsoft Excel (ability to sort, filter, and create simple spreadsheets), Microsoft Outlook (email and calendar management) and Microsoft PowerPoint (creating slides and presentations)
• Knowledge of medical claims processing and repricing methodologies
• Communication, problem-solving, and organizational skills
• Ability to work full-time, Monday – Friday, in any of our 8-hour shift schedules during our normal business hours of 7:00am – 6:00pm CST

                                                 

Preferred Qualifications:

• Sales or account management experience
• Facets (CMC or CSP) system knowledge
• Medicare or Medicaid Claim knowledge
• Experience supporting payer clients or third-party administrators
• Proficiency in Adobe Professional

                                                 

Telecommuting Requirements:

• 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

                                                 

Soft Skills:

• Demonstrated ability in customer service problem resolution and relationship building
• Ability to manage multiple priorities and navigate cross-functional teams in a fast-paced environment
• Ability to multi-task including ability to understand multiple products and multiple levels of client relationships within each product
• Written and oral communication skills adaptable to live phone conversations as well as e-mail that drive a trusted relationship based on ownership reducing customer effort 
• Ability to quickly build rapport and respond to clients in a compassionate manner by identifying and exceeding client expectations (responding in respectful, timely manner and delivering on commitments) 
• Ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the clients

                                                 

*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 offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 – $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

                                                 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

                                                 

                                                 

UnitedHealth Group is 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 is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

                                                 

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