Service Account Manager Associate - National Remote

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

At UnitedHealthcare, 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 doing your life’s best work.^SM

This role is equally challenging and rewarding. Within a high-volume environment, you’ll need to model and act as an ambassador for the company while solving complex health care inquires The Service Account Manager Associate acts as a customer advocate to resolve escalated and complex issues.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

We offer weeks of paid training. The hours during training will be discussed. 

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

Primary Responsibilities:

• Works independently to manage own tasks and applies knowledge/skills to a range of complex activities
• Demonstrates great depth of knowledge/skills in own function and increased knowledge/skills in other functions such as coding, networks, integration, HRA, HCR regulations, etc.
• Proactively identifies non-standard requests and potential problems; investigates and solutions using defined processes, expertise, and judgement.  Resolution is determined by use of knowledge, research, and internal contacts.
• Identify potential claim and / or customer service issues during implementation and create a plan to ensure risk is minimized
• Consults with key business partners outside of team to ensure benefit intent is understood based on source documents and output matches. (Coding, SAE, PNO, network services, integration support).
• Serve as the liaison to a complex customer base to manage first level response and resolution of escalated issues with external and internal customers
• Identify and resolve operational problems using defined processes, expertise, and judgment
• Investigate claim and / or customer service issues as identified and communicate resolution to customers
• Responsible for maintaining customer’s medical plans installation documents
• Responsible for testing customer benefit changes in CPS
• Create and update HPDB’s
• Identify the need for and providing specific and remedial training to processors or CFR’s
• Large claim file reviews
• Monitor large dollar claims - for stop loss
• Respond to SBA and external vendor audits
• May act as a resource for others
• May coordinate other activities

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 higher)
• 1 years of Medical Claim processing experience  
• 2 years of Customer Service experience analyzing and solving customer's problems
• 1 years of experience reading Medical Plan documents with full understanding of HRA, HSA, PPO and indemnity plan benefits, deductible, coinsurance and copay and standard plan exclusions
• Basic proficiency with Windows computer applications, which includes the ability to learn new and complex computer system applications
• Ability to work full-time, Monday – Friday from 8:00am - 5:00pm CST

Preferred Qualifications:

• 1 years of CPS medical claim experience within UMR OR 2 years Medical Claim call or claim processing experience within a  claim system other than CPS.
• Medical coding and Medical Benefit knowledge
• Experience with UMR CPS (Must be within UMR business line)
• Experience working within cross functioning departments of UMR
• Experience working with members, providers, and customers regarding their medical claims
• Experience with Microsoft Excel (creating basic formulas, creating, and managing pivot tables)
• Experience utilizing Word (creating and editing documents) and Microsoft Outlook (creating and sending emails)

Telecommuting Requirements:

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

California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / New Jersey / Washington / Rhode Island residents is $18.80 - $36.78. The hourly range for New York residents is $18.80 - $36.78 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives,

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.

#RPO #GREEN