If you are located within the state of New Mexico, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

AtUnitedHealthcare, we’re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doingyour life’s best work.^SM

The Provider Customer Service Representative will be supporting providers that care for our 50 million members. In this role, you will serve healthcare professionals who are fluent in healthcare terminology, often with many years of experience across multiple payers. These healthcare professionals expect to receive timely, confident, and thorough responses to questions that span the full continuum of care delivered to a member, which may include, Benefits and eligibility, Billing and payments, Clinical authorizations, Explanation of benefits, and Behavioral health.

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm MST. It may be necessary, given the business need, to work occasional overtime. 

We offer 16 weeks of paid training. The hours during training will be 8:30 am to 4:30 pm CST Monday-Friday.Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues
• Quickly and appropriately triage contacts from healthcare professionals (i.e. physician offices, clinics, billing offices)
• 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)
• Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls, escalations, and provider dissatisfaction
• Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner
• 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
• Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution

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 / GED OR equivalent work experience
• Must be 18 years of age OR older
• 1 years of customer service experience analyzing and solving customer’s concerns.
• Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Abilityto work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm MST. It may be necessary, given the business need, to work occasional overtime. 

Preferred Qualifications:

• Prior health care experience and knowledge of healthcare terminology
• Experience in a related environment (i.e., office, call center, customer service, etc.) using phones and computers as the primary job tools

Telecommuting Requirements:

• Reside within the state of New Mexico
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

Soft Skills:

• Typing Speed greater than or equal to 35-40 WPM with accuracy of 90%
• Ability to remain focused and productive with changing priorities and repetitive tasks
• Ability to resolve calls and messages, avoiding escalated complaints.
• Time management skills
• Emotional Intelligence and Empathy
• Active Listening and Comprehension
• Excellent written communication skills.
• Demonstrated problem solving, organization and interpersonal skills.
• Demonstrated experience consistently achieving quality and productivity standards.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, 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.

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

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