Provider Customer Service Call and Chat Representative - Remote in Dublin, OH

About the position At UnitedHealthcare, we are dedicated to simplifying the health care experience and creating healthier communities. As a Provider Customer Service Call and Chat Representative, you will play a crucial role in supporting providers who care for our members. This position involves responding to inquiries related to benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits (EOB), and behavioral health, either through phone calls or concurrent chat. You will be part of a full-time team working 40 hours a week, Monday through Friday, with shifts scheduled during our normal business hours of 11:35 AM to 8:05 PM EST. Given the nature of the business, there may be occasional overtime, weekend, and holiday work required, especially during peak seasons. The role includes a comprehensive 10-week paid training program, where attendance is mandatory, and no paid time off (PTO) is allowed during this period. As a telecommuter, you will need to adhere to UnitedHealth Group's Telecommuter Policy, which includes maintaining a dedicated workspace and ensuring the security of sensitive company documents. Your primary responsibilities will include advocating for providers, triaging contacts from healthcare professionals, resolving complex issues, and collaborating with internal partners to ensure timely communication and resolution of provider concerns. You will also be expected to influence providers to utilize self-service digital tools to enhance their experience and expedite issue resolution. This position offers a unique opportunity to make a significant impact on the health care system while developing your skills in a supportive environment. You will be recognized for your performance and provided with clear direction for success in your role, as well as opportunities for career development within the organization.

Responsibilities

• Serve as the advocate for providers by demonstrating accountability and ownership to resolve issues.

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• Service providers in a multi-channel environment including call and concurrent chat as required.

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• Quickly and appropriately triage contacts from healthcare professionals (i.e., physician offices, clinics, billing offices).

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• Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health).

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• Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls/messages, escalations, and provider dissatisfaction.

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• Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner.

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• Strong multitasking to effectively and efficiently navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types.

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• Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution.

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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• 1+ years of customer service experience with analyzing and solving customer's concerns.

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• Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications.

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• Ability to type at the speed of greater than or equal to 35 - 40+ WPM (words per minute) with an accuracy of 90%.

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• Ability to work any full-time (40 hours/week), 8-hour shift between the hours of 11:35 AM - 8:05 PM EST from Monday - Friday.

Nice-to-haves

• Experience in a related environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools.

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• Prior health care experience and knowledge of healthcare terminology.

Benefits

• 10 weeks of paid on-the-job training.

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• Flexible telecommuting options for those within a 60-mile commutable distance.

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• Opportunities for career development and advancement within the organization.

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