IFP Customer Service Advocate – National Remote

About the position

At UnitedHealthcare, we are dedicated to simplifying the health care experience and creating healthier communities. As an IFP Customer Service Advocate, you will play a crucial role in this mission by assisting customers with their health benefits inquiries. This position allows you to work remotely from anywhere in the U.S., providing you with the flexibility to balance your work and personal life while making a significant impact on the lives of millions. You will be responsible for answering incoming calls from customers, addressing their questions about health benefits, and guiding them through the enrollment process for new plans. This role is not just about answering questions; it’s about being an advocate for our customers and ensuring they receive the support they need. In this inbound call center position, you will spend approximately 7 to 7.5 hours a day on the phone, handling 50-70 calls from our Individual Family Plans population. You will be expected to navigate multiple computer systems and platforms to provide accurate information and resolve issues in real-time. Your ability to multi-task and show compassion will be essential, as you will be working with a vulnerable population that may require additional support. You will also be required to meet monthly performance goals, which include efficiency, accuracy, quality, member satisfaction, and attendance. The position is full-time, requiring 40 hours of work per week, Monday through Friday, with flexibility to work any of our 8-hour shift schedules during normal business hours (7:00 a.m. – 6:00 p.m. CST). Training will be provided virtually for 11 weeks, ensuring you are well-prepared to take on the challenges of the role. You will be rewarded for your performance and have opportunities for career development within the organization.

Responsibilities
• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs))
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• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
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• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
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• Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
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• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
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• Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
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• Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance

Requirements
• High School Diploma / GED OR equivalent work experience
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• Must be 18 years of age OR older
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• 2+ years of customer service experience
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• Ability to work full-time, Monday – Friday between 7:00am – 6:00pm CST including the flexibility to work occasional overtime given the business need

Nice-to-haves
• Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)
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• Social work, behavioral health, disease prevention, health promotion and behavior change (working with vulnerable populations)
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• Sales or account management experience
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• Bilingual fluency in English and Spanish

Benefits
• Comprehensive benefits package
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• Incentive and recognition programs
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• Equity stock purchase
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• 401k contribution