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Peoples Health Member Services Representative - Bilingual Spanish - Metairie, LA

UnitedHealth Group Metairie Full-Time
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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.

A typical day for a Peoples Health Member Services Representative begins with Representatives taking to their work stations and organizing them and setting up their resources to maximize their success in handling calls.  That includes reviewing emails, the intranet, the department’s dashboard, and team performance from the previous day.  After ensuring preparedness, Representatives log onto the phone system and make themselves available to assist callers.

Some days are busier than others and require you to hit the ground running and handle a lot calls while remaining engaged, empathetic, and helpful to the caller. Often times callers are dealing with health and / or financial issues that add a sense of urgency to their requests, and you have to maintain a balance between advocating for members, and business processes that make the company successful. At all times, the customer is at the center of what you do. On slower days, you follow up on outstanding action items that you routed to other departments, and conduct follow - up calls with members to close out their contact. You’re always learning something new and expanding your knowledge of the industry and the population of members we serve. It can be a very rewarding experience. 

Primary Responsibilities:

  • The Peoples Health Member Services Representative handles inquiries, concerns, complaints, grievances and appeals in a professional manner by listening to the member and showing respect. When appropriate, the Representative takes action to resolve complaints to ensure member retention and satisfaction by following department guidelines or contacts immediate supervisor for intervention
  • Educates members, customers (internal / external) while effectively promoting Peoples Health products, services, and policies on the telephone as well as face - to - face communication
  • Acts in accordance with Peoples Health vision and values. Participates and supports development programs, active in staff meetings, and performs company educational offerings as well as demonstrating the willingness to work as a team member when needed for additional tasks to ensure excellent service
  • Ensures that supplies are sufficient to perform their duties, maintains equipment in proper place after usage and maintains workspace in an orderly fashion
  • Acts as an efficient liaison for the member and effectively documents 100% of their communication in the service module achieving a clear link between subject line, category, sub - category and free text
  • As needed, handles requests for transportation to participating providers and return trip requests. Properly utilizes the transportation database. Generates denial letters when needed. When requested, prepares daily schedules for vendors and reporting requirements.
  • The Representative must become familiar with standard healthcare concepts, practices, and procedures as they relate to claims adjudication and managed care
  • Complete special assignments in an accurate and efficient manner with little intervention from management.

Required Qualifications: 

  • High School Diploma / GED (or higher)
  • Bilingual skills in English and Spanish
  • Experience in a call center environment or related customer service field
  • Prior healthcare experience
  • Basic computer navigation skills with experience in a Windows environment
  • Experience with Microsoft Office Suite: Microsoft Excel (enter information, save files, navigate through worksheet), Microsoft Word (create documents), Microsoft Outlook (organize email)
  • Experience with Internet - utilize web - based internal applications

Preferred Qualifications:

  • Experience with Microsoft Access (data entry into an existing database, run standard reports)
  • Amisys experience

Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in healthcare. And we are the largest business in the nation dedicated to serving their unique health and well - being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our Healthcare system. Ready? It's time to do your life’s best work.SM

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.

Keywords: UHG, UHC, M&R, PeoplesHealth, member services representative, call center, healthcare, Amisys

 

Skills required

Customer Service
Telephone Consultations
Confidentiality
Listening
Answer Question
Membership Policies

Location

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Peoples Health Member Services Representative - Bilingual Spanish - Metairie, LA
Estimated Salary: $64K
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Job ID: 2551_806614

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UnitedHealth Group is Fortune 5 and working to create the health
care system of tomorrow.  We can’t do it alone.  We need your help,
skills and drive to serve others.  
Consider your future: workatuhg.com

Our industry is focused on innovation and change. You can expect
to work a little harder, because we aim a little higher to meet the rapidly
evolving needs of healthcare.  We expect more from ourselves as well as
those who share our passion for excellence. If you’re open to that challenge,
you’ve come to the right place. Yes, we’ll test your skills, then help you to
build more. 

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.

If you would describe yourself as compassionate, decisive, and
built for speed, we want to hear from you.  This is the place to share
your ideas and your passion for making a difference right now. We won’t promise
you the world, but we will promise you the opportunity to do
your life’s
best workSM


Because we recruit talent for a diverse range of areas - from
finance and nursing to customer service, marketing, legal and beyond – chances
are, we’ll have an opportunity for you.

UnitedHealth Group Values:

Just like you, we’re driven by values that are guiding our way
forward:

Integrity
– Honor commitments. Never compromise ethics. 
Compassion – Walk in the shoes of people we serve, and those with whom
we work.
Relationships – Build trust through collaboration.
Innovation – Invent the future, learn from the past.
Performance – Demonstrate excellence, in everything we do.

With these values as our foundation, and through the talents,
drive and compassion of people like you, UnitedHealth Group will transform
health care. And we’ll continue our evolution as a company, making an even
greater positive impact on the lives of those we serve. 

Consider your future:
workatuhg.com

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