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Bilingual (Korean and Eng) Customer Service Advocate - Flushing, NY

UnitedHealth Group


Location:
Flushing, NY
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1736181
Apply on the Company Site
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Job Details


Bilingual (Korean and Eng) Customer Service Advocate - Flushing, NY(Job Number:709350)
Description

Position Description:


Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.


Positions in this function are responsible for providing expertise and customer service support to members as part of our UnitedHealthcare Advocate4Me model. Direct phone-based customer interaction to address complex member needs and provide recommendations on services that may help close gaps in care for the member and/or the member's family. May authorizes claims payments or refer claims to investigators for further review.


Primary Responsibilities:
  • Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
  • Effectively refers and enrolls members to appropriate internal specialists and programs, based on member's needs and eligibility
  • Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence.
  • Resolve member service inquiries related to:
  • Medical benefits, eligibility and claims
  • Terminology and plan design
  • Financial spending accounts
  • Pharmacy benefits, eligibility and claims
  • Correspondence requests
  • Educate members about the fundamentals of health care benefits including:
  • Managing health and well being
  • Maximizing the value of their health plan benefits
  • Choosing a quality care provider and appointment scheduling
  • Pre-authorization status
  • Assist members in appointment scheduling to proactively address gaps in care
  • Intervene with care on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
  • Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues.
  • Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance
  • Maximizes use of community services, support programs, and resources available to member
  • Extensive work experience within own function.
  • Work is frequently completed without established procedures.
  • Works independently.
  • May act as a resource for others.
  • May coordinate others' activities.

 


Job Advocate4Me
Primary Location US-NY-Flushing
Other Location 
Organization E&I Local Markets Dist Strat
Schedule Full-time
Number of Openings 2
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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