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The purpose of this role is to interact with members regarding medical and pharmacy benefits, eligibility and claims issues and to assist with plan selection and enrollment. This role is expected to identify opportunities to connect members to the best resources to meet their healthcare needs and provide support in order to resolve medical and benefits issues on behalf of a member. The Bilingual Vietnamese Customer Service Advocate builds trust with members across their health care lifecycle.
- Provide in - language service to Vietnamese and English speaking customers over the phone
- Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow - up with the member
- Effectively refers and enrolls members to appropriate internal specialists and programs, based on members' needs and eligibility
- Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence.
- Resolve member service inquiries related to: Medical benefits, eligibility and claims, terminology and plan design, financial spending accounts, pharmacy benefits, eligibility, and claims, and correspondence request.
- Educate members about the fundamentals of health care benefits including: Managing health and well - being, maximizing the value of their health plan benefits, selecting the best health plan to meet their health needs, choosing a quality care provider and appointment scheduling, premium provider education and steerage, and pre - authorization and pre - determination requests and status
- Assist members in appointment scheduling to proactively address gaps in care
- Intervene with care on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
- Research complex issues across multiple databases and work with support resources to own the resolution of all customer issues and anticipate their future healthcare needs or potential opportunities to improve the experience
- Provide education and status on previously submitted pre - authorizations or pre - determination requests
- Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance
- Maximizes use of community services, support programs, and resources available to members
- High School Diploma / GED
- Bilingual fluency (verbal and written) in Vietnamese and English
- 1+ years in a Customer Service environment with proven customer service skills and experience working in retail, call centers, or any other professional setting
- Ability to work regularly scheduled shifts within our hours of operation (Monday to Friday 9:00 AM to 8:30 PM eastern time), where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work overtime and / or weekends, as needed
- Ability to successfully complete the UnitedHealthcare Operations new hire training and demonstrated proficiency and the UnitedHealthcare Operations Customer Service Advocate training classes and demonstrate proficiency of the material
- Associate’s Degree (or higher)
- Experience in a Health Care / Insurance environment - Familiarity with medical terminology, health plan documents, or benefit plan design
- Previous experience in translating healthcare - related jargon and complex processes into simple, step - by - step instructions customers can understand and act upon
- Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner and delivering on commitments)
- Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
- Ability to overcome objections and persuade members to take action / change behavior
- Ability to utilize multiple systems / platforms while on a call with a member – strong computer skills and technical aptitude
- Proficient problem solving approach to quickly assess current state and formulate recommendations
- Flexibility to customize approach to meet all types of member communication styles and personalities
- Excellent conflict management skills including: Professionally and adeptly resolve issues while under stress, diffuse conflict and member distress, and demonstrate personal resilience
- Strong verbal and written communication skills.
- Solid time management skills
- Strong attention to detail
Physical Requirements and Work Environment:
- Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer
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.
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: Bilingual, Vietnamese, Customer Service, Call Center, UHC, UnitedHealthcare, UHG, UnitedHealth Group