Customer Service Representative - Newark, NJ

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.



AmeriChoice, a UnitedHealth Group company, is a recognized leader and innovator in providing managed health care solutions to its Medicaid membership.  With over a decade of growth and success we are poised for continued expansion of our services in this dynamic marketplace. Our commitment to this specialized market makes a genuine difference in thousands of lives. Join us, do rewarding work, and build a great career.


 


Job Responsibilities:



To answer incoming calls from providers and members, as well as participate in the proactive outbound call program.


Resolve basic types of customer service call inquiries including: Benefits Eligibility, Member material requests, Provider lookup, Authorization, Basic member administration.


Locate Explanation of Benefits (EOB).

Resolve complex customer service inquiries including: Claim status, Claim explanation, Claim adjustments.

Establish and maintain control of inbound calls using a well organized structure.

Participate in proactive outbound call program (i.e., welcome calls) to ensure customer satisfaction, when applicable.

Provide excellent customer service to both members and providers by quickly and accurately identifying and assessing individual provider and member needs and taking appropriate action steps to satisfy those needs.

Solve problems, systematically, using sound business judgment and follow through on commitments.

Respond to customers in a polite and courteous manner, especially in stressful situations.

Project patience, empathy, caring and sincerity in voice tone and words.

Establish rapport over the phone quickly, and remain positive and upbeat over prolonged periods of customer service

Express thoughts and information clearly and succinctly.

Inspire confidence and positively influence the behavior, actions and thoughts of others.

Communicate unpleasant or negative information in a tactful manner.

Ensure proficiency in all product lines instructed in classroom training.

Consistently meet established productivity, schedule adherence and quality standards.

Learn new skills and retain large amounts of information, facts, rules, procedures and codes.

Demonstrate the ability to build and maintain productive working relationships with others and contribute as an effective team member.

Begin to serve as a mentor to Customer Service Associate staff by providing advice when needed.

Developing skills and building capabilities that will enable the individual to serve as a resource for other members of the team.

Actively seek out process improvement opportunities.



Job Qualifications:


Associate Degree or equivalent work experience.

Prior customer service experience.

Bilingual - Write, speak and read (Spanish) required.

PC Skills (Word/Excel/Access).

Strong customer service orientation.

Ability to interpret electronic data and apply to customer service calls.

Strong English, written and oral communication skills.

Excellent organization and interpersonal skills.

Attention to detail.

Quality focused.

Decision making skills.

Organizational skills.

Works independently as well as apart of a team.

Adjusts quickly and reacts positively to change.

Driver's license and access to a registered, insured vehicle.

Previous social work, community outreach, and/or managed care experience desired.


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