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Senior Customer Service Rep - San Antonio, TX

UnitedHealth Group

San Antonio, TX
Job Code:
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Job Details

Senior Customer Service Rep - San Antonio, TX(Job Number:704013)

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.(sm)


The Senior Customer Service Representative is responsible for handling all incoming Billing and Eligibility phone calls and for serving as the primary customer interface for departmental inquiries.

Primary Responsibilities:

  • Ensures quality customer service for internal and external customers

  • Responds to incoming customer service requests, both verbal and written

  • Identifies and assesses customers' needs quickly and accurately

  • Solves problems systematically, using sound business judgment

  • Partners with other billing and eligibility department representatives to resolve complex customer service inquiries

  • Monitors delegated customer service issues to ensure timely and accurate resolution

  • Applies appropriate communication techniques when responding to customers, particularly in stressful situations

  • Informs and educates new customers regarding billing / invoicing set up and billing / payment procedures

  • Places outgoing phone calls to complete follow-up on customer service requests as necessary

  • Responds to customer service inquiries in writing as necessary

  • Processes member terminations (i.e. phone disenrollment)

  • Establishes and demonstrates competency in eligibility, billing and receivable systems and associated applications. Implements customer service strategies and recommends related improvements / enhancements

  • Maintains timely, accurate documentation for all appropriate transactions

  • Makes corrections and adjustments

  • Consistently meets established productivity, schedule adherence, and quality standards

  • Proactively seeks to further develop billing and accounts receivable competencies

  • Keeps management abreast of all outstanding issues

  • Adapts procedures, processes, and techniques to meet the more complex position requirements

  • Participates in load balancing

  • Addresses special (ad-hoc) projects as appropriate

  • Seeks involvement in continuous quality improvement initiatives

  • Clearly communicates claims status, payment methodology, contract terms, procedures, etc. to customer

  • Identifies trends in errors or inquiries and reports these to appropriate personnel

  • Informs and assists callers with the claims appeals process, if necessary

  • Develops a tracking system to ensure that all priority issues are handled within established time frames and proactively notifies customers of anticipated delay

  • Answer customer service lines promptly and professionally and maintain at least a 95% response time

  • Demonstrate excellent customer service by determining the reason for the call, acknowledging the callers concerns and resolve concerns and/or explain action to be taken within the expected time line for resolution

  • Performs research on complex claim inquiries and expertly re-examines claims

  • Serves as a resource to medical group staff, network providers, health plan representatives and claims staff

  • Presents a pleasant voice to all callers, regardless of the stressful nature of the situation

  • Performs all other related duties as assigned

Job Phone Support
Primary Location US-TX-San Antonio
Other Location 
Organization WellMed Medical Mgmt, Inc
Schedule Full-time
Number of Openings 1
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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