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  • San Antonio, TX

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Bilingual (Spanish / English) Customer Service and Claims Representative - Telecommute - San Antonio, TX

UnitedHealth Group • San Antonio, TX

Posted 17 days ago

Job Snapshot

Healthcare - Health Services
Customer Service


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Job Description

Cuando se trata
de salir adelante y tienes la voluntad de ganar, vamos a llamarlo gran potencial
de carrera!

If you are located
within 50 miles of San Antonio, you will have the flexibility to telecommute* as
you take on some tough challenges.You like working with people. Even more so,
you like helping them. This is your chance to join a team dedicated to helping
our members and their families every day. In this joint role as a Bilingual (Spanish/English) Customer Service and Claims
, you'll join us on a mission to not only deliver the best
customer service in the health care industry, but the best customer service.
Period. Your compassion and customer service expertise combined with our
support, training and development will ensure your success. This is no small
opportunity. This is where you can bring your compassion for others while
doing your life's best work. sm

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

In this role, you
play a critical role in creating a quality experience for the callers that you
connect with and those that you correspond with. Every interaction gives you
that opportunity to improve the lives of our customers and exceed their
expectations. You'll spend the majority of your day by responding to calls from
our members and help answer questions and resolve issues regarding health care
eligibility, claims and payments. You'll also spend a portion of your time
reviewing, researching and processing healthcare claims with the goal to ensure
that every claim has a fair and thorough review.

To learn even more about this position, click here to watch a short video
about the job:  (Note:
these videos are labeled with our internal job title of Customer First

This position is
full-time (40 hours/week) Monday - Friday. Employees are required to have
flexibility to work any of our 8 hour shift schedules during our normal business
hours of (7am - 9pm). It may be necessary, given the business need, to work
occasional overtime or weekends. This will be a work at home / telecommute role
after training, which will be conducted onsite in our office at 12668 Silicon
Drive, San Antonio, TX 78249. It may be necessary to attend occasional meetings
onsite as well. Please review our telecommute requirements below.

Candidates must
reside within 50 miles of our office and be available to complete training
according to the following schedule:

  • Training Session 1, conducted in our office, with a duration of
    8-9 weeks of classroom training
  • Work from home for approximately 3 months
  • Training Session 2, conducted in our office, with a duration of
    4 weeks


  • Answer incoming phone calls from customers and identify the
    type of assistance the customer needs (i.e. benefit and eligibility, billing and
    payments, authorizations for treatment and explanation of benefits
  • Ask appropriate questions and listen actively to identify
    specific questions or issues while documenting required information in computer
  • Own problem through to resolution on behalf of the customer in
    real time or through comprehensive and timely follow-up with the
  • Review and research incoming healthcare claims from members and
    providers(doctors, clinics, etc) by navigating multiple computer systems and
    platforms and verifies the data/information necessary for processing (e.g.
    pricing, prior authorizations, applicable benefits)
  • Ensure that the proper benefits are applied to each claim by
    using the appropriate processes and procedures (e.g. claims processing policies
    and procedures, grievance procedures, state mandates, CMS/Medicare guidelines,
    benefit plan  documents/certificates)
  • Communicate and collaborate with members and providers to
    resolve issues, using clear, simple language to ensure understanding
  • Meet the performance goals established for the position in the
    areas of: efficiency, accuracy, quality, member satisfaction and


  • Spanish Bilingual Required
  • Prefer 1 year experience in an office setting,  call center
    setting or phone support  role, but not required
  • Previous experience working at home/telecommuting is preferred,
    but not required
  • An education level of at least a high school diploma or GED OR
    10 years of equivalent working experience
  • Demonstrated ability in using computer and Windows PC
    applications, which includes strong keyboard and navigation skills and learning
    new computer programs
  • Ability to multi-task  duties as well as the ability to
    understand multiple products and multiple levels of benefits within each
  • Ability to work regularly scheduled shifts within our hours of
    operation including the training period, where lunches and breaks are scheduled,
    with the flexibility to adjust daily schedule, and work over-time and/or
    weekends, as needed
  • All new hires will be required to successful complete the
    Customer Service  training classes and demonstrate proficiency of the


  • Reside within 50 miles of San Antonio, TX with the ability to
    attend onsite training
  • Required to have a dedicated work area established that is
    separated from other living areas
  • Required to have a work area in a section of the residence that
    provides information privacy
  • Required to keep all Company sensitive documents
  • Required to have lockable drawers for the securing of
    confidential information
  • Must live in a location that can receive a UnitedHealth Group
    approved high-speed internet connection or leverage an existing high-speed
    internet service

There are several
steps in our hiring process - it’s a thorough process because we want to ensure
the best job and culture fit for you and for us. In today’s ultra-competitive
job market, the importance of putting your best foot forward is more important
than ever. And you can start by completing all required sections of your
application. (i.e. profile, history, certifications and application/job
questions). Once you submit your resume, you’ll receive an email with next
steps. This may include a link for an  on-line pre-screening test(s) (or what we
call an assessment) that we ask you to complete as part of our selection
process.  You may also be asked to complete a digital video interview, but we
will offer full instructions and tips to help you. After you have completed all
of these steps, you can check on the status of your application at any time, but
you will also be notified via e-mail.

Careers at UnitedHealthcare Employer &
 We all want to make a difference with the work we do. Sometimes
we're presented with an opportunity to make a difference on a scale we couldn't
imagine. Here, you get that opportunity every day. As a member of one of our
elite teams, you'll provide the ideas and solutions that help nearly 25 million
customers live healthier lives. You'll help write the next chapter in the
history of health care. And you'll find a wealth of open doors and career paths
that will take you as far as you want to go. Go further. This is your life's
best work.SM

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.

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

Keywords: customer
service representative, customer service, CSR, UnitedHealth Group, call center,
UnitedHealthcare, health care, office, phone support, training class,
work at home, telecommute, WAH, San Antonio

Job ID: 2551_769021
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