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Spanish Bilingual Senior Customer Service Representative - Miami, FL

UnitedHealth Group

Miami, FL
Job Code:
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Job Details

Spanish Bilingual Senior Customer Service Representative - Miami, FL(Job Number:725267)

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.

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed.

Within this role, the focus is to reach out and interact with members / providers in order to assist members in completing preventive screenings and adhering to their medications within specific STARS focus measures such as: Osteoporosis Management in Women (OMW), Medication Adherence  (Diabetes, Hypertension and Cholesterol measures), Breast Cancer Screening (BCS), Colorectal Cancer Screening (COL), Rheumatoid Arthritis (ART), and Comprehensive Diabetes Care (CDC)– Diabetes Care – Eye Exams, etc.

Primary Responsibilities:

  • During direct phone based Customer interaction encourage members to use their benefits to seek appropriate care, complete preventive screenings tests, and adhere to their medications
  • Work collaboratively with physicians and other health care providers to proactively assist members with coordinating appointments, requesting prescriptions, and arranging transportation
  • Ensures quality customer service for internal and external customers
  • Responds to incoming customer service requests, both verbal and written relating to STARS measures. Will also route / escalate member concerns through appropriate channels
  • Identifies and assesses customers' needs quickly and accurately
  • Places outgoing phone calls to complete follow-up on customer service STARS related measures
  • Responds to customer service inquiries or routes inquiries to appropriate departments as necessary
  • Establishes and demonstrates competency in eligibility, billing and receivable systems and associated applications (e.g. Cosmos, Facets, Diamond, RxClaims, SAM) in regard  to STARS related measures or routes member / provider questions to appropriate department
  • Implements customer service strategies relating to STARS Outreach Measures and recommends related improvements / enhancements
  • Maintains timely, accurate documentation for all appropriate transactions
  • Flexibility to customize approach to meet all types of member communication styles and personalities
  • Consistently meets established productivity, schedule adherence, and quality standards
  • Keeps management abreast of all outstanding issues

Job Phone Support
Primary Location US-FL-Miami
Other Location 
Organization M&R Pref Care Partners Admin
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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