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Customer Service Representative

UnitedHealth Group

This is a Full-time position in El Paso, TX posted June 25, 2021.

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

Under minimal supervision this position is responsible for responding to referral requests generated via computer, fax, or telephone. Answers all incoming calls via Automatic Call Distribution and making outbound calls to obtain demographic, referral information, verify insurance eligibility, benefits and obtain authorization as needed.

Primary Responsibilities:

  • Demonstrated ability to handle 35+ calls and 15+ referrals during an 8 – hour shift, facilitating a positive patient experience
  • Maintain 98% accuracy on all patient documentation and referral information in patient’s account
  • Obtains prior authorization and secures co-pay as defined by policy
  • Routes referral and patient information to the appropriate venue and notifies referral source of disposition when unable to accept referral
  • Resolves questions and problems, and refers only the most complex issues to higher levels
  • Adhere to all written policy and procedures
  • Provides mentorship to other representatives during introductory period

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 or equivalent
  • 2+ years of experience with customer service in a call center environment
  • Knowledge of Medicare, HMO, and standard insurance verification processes
  • Windows computer systems skills and ability to learn new programs
  • Bilingual in both Spanish and English
  • Ability to work an on – call shift at least once a month
  • This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor’s diagnosis of disease
  • You will be asked to perform this role in an office setting or other company location
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

  • Customer service experience in a healthcare and/or insurance office
  • Medical terminology, ICD coding or CPT coding
  • Knowledge of durable medical equipment and medical supplies

Careers with WellMed. Our focus is simple. We’re innovators in preventative health care, striving to change the face of health care for seniors. We’re impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We’ve joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life’s best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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

Job Keywords: Bilingual Customer Service Representative, Customer Service Representative, CSR, Customer Service, Call Center, Medicare, HMO, Standard Insurance Verification Process, Verification Process, Bilingual, Spanish, English, El Paso, TX, Texas

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