Customer Service Representative - Las Vegas, NV Job at UnitedHealth Group

UnitedHealth Group Las Vegas, NV 89128

$1,500 Sign On Bonus For External Candidates

If you are located in Las Vegas, NV , you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

At UnitedHealthcare , we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work. SM

In this role, you play a critical role in creating a quality experience for the callers that you connect with and those that you correspond with. Every interaction gives you that opportunity to improve the lives of our customers and exceed their expectations. You'll spend the majority of your day by responding to calls from our members and help answer questions and resolve issues regarding health care eligibility, claims and payments. You'll also spend a portion of your time reviewing, researching and processing healthcare claims with the goal to ensure that every claim has a fair and thorough review.

This position is full-time (40 hours/week) Monday - Friday. This position is a hybrid onsite/ work from home role. Employees are required to have flexibility to work an 8 hour shift Monday- - Friday from 7 am-4 pm PST. Week 1: 4 days working at Las Vegas office, 1 day a week at client location. Emergency backup for onsite personnel with 24 hours notice and back up for scheduled vacations.
Week 2: 1 day at client location, 4 days’ work from home. Emergency backup for onsite personnel with 24 hours’ notice and back up for scheduled vacations

Hybrid onsite/ work from home:
Office Location: 2650 N TENAYA WAY, LAS VEGAS, 89128
Client Locations:
1. Las Vegas Metro PD: 400 S. Martin Luther King Blvd, Las Vegas NV 89106
2. Sands - The Venetian: 3355 Las Vegas Blvd S, Las Vegas, NV 89109

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary 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)
  • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
  • Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
  • 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)
  • 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)
  • Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
  • Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance

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 higher)
  • All new hires will be required to successfully complete the Customer Service training classes and demonstrate proficiency of the material
  • Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:

  • 2+ years customer service OR experience in the healthcare industry

Telecommuting Requirements:

  • Must be available to work onsite at our office and client locations: Office Location: 2650 N TENAYA WAY, LAS VEGAS, 89128. Client Locations: 1. Las Vegas Metro PD: 400 S. Martin Luther King Blvd, Las Vegas NV 89106 2. Sands - The Venetian: 3355 Las Vegas Blvd S, Las Vegas, NV 89109. Will function as on-site backup expected to go on site for coverage with 24 hour notice.
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • 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 to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments)
  • Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
  • Proficient problem-solving approach to quickly assess current state and formulate recommendations
  • Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
  • Flexibility to customize approach to meet all types of member communication styles and personalities
  • Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience
  • Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

Nevada Residents Only: The salary range for Nevada residents is $16.83 - $29.66. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

# RPO, #RED




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