Call Center Representative (Provider Inquiry) – San Juan, PR

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

 

The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it’s reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you’ll help understand and overcome errors in claims processing. You’ll have all the tools and backing you need to help manage subrogation files, negotiate settlements and ensure adherence to compliance policies.

 

When you are in the business of health care, you’re in the business of people. At UnitedHealth Group we want every customer experience to be distinctly personal. The challenge is complex. When people call us for help, their focus is on getting the best care possible. We help them understand their benefits and their options. This part of their lives matters a lot to them and it matters just as much to us. Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.

 

As Provider Inquiry Call Center Representative you will be accepting and directing all incoming phone calls according to policy and procedures and department productivity and quality standards. Resolves routine to moderately complex issues, refers appropriately to Team Lead and/or Supervisor as needed.

 

Primary Responsibilities:

• Ensures quality customer service for internal and external customers
• Handles all incoming phone calls and identifies/assess customers’ needs accurately and timely regarding potential third party liability
• Solves problems systematically, using sound business judgment
• Applies appropriate communication techniques when responding to customers
• Recommends customer service strategies and related improvements/enhancements
• Maintains timely, accurate documentation for all phone call interactions
• Consistently meets established productivity, schedule adherence, and quality standards
• Seeks involvement in continuous quality and process improvement initiatives when warranted

***ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION*** 

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:

• 1+ years of call center experience
• Experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
• Fully Bilingual Spanish/English proficiency
• Willing or ability to work 40 hours / week during standard business operating hours Monday – Friday from 8am – 9:30pm AST. (It may be necessary, given the business need, to work Holidays, weekends and occasional overtime)

 

Preferred Qualifications:

• Experience within the healthcare industry
• Experience in claims
• Proven knowledge of medical terminology
• Proficiency with MS Office

 

 

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.