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.
Turn on the news on any night of the week and you're likely to hear about the changes that are sweeping through our health care system. It's dramatic. It's positive. And it's being led by companies like UnitedHealth Group . Now, you can take advantage of some of the best training and tools in the world to help serve our existing and new customers. You'll provide face to face service to customers who have questions about their health benefits. As their advocate, you'll use your personality and our tools to help them through the health care benefits available to them, including helping them enroll in a new plan. This is no small opportunity.
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 Korean and English Retail Customer Service Specialist builds trust with members across their health care lifecycle.
- Provide in language service to Korean and English speaking customers at retail walk in center
- Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow - up with the member
- Respond to and resolve on the first visit, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims and correspondence.
- Resolve member service inquiries related to:
- Medical benefits, eligibility and claims
- Terminology and plan design
- Pharmacy benefits, eligibility and claims
- Correspondence requests
- Educate members about the fundamentals of health care benefits including:
- Managing health and well being
- Maximizing the value of their health plan benefits
- Choosing a quality care provider and appointment scheduling
- 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 and government assistance programs and services. Identify resources available to members and help members apply for much needed subsidies
- Perform Medicare health plan consultation and enrollment. Helping customers select the most suitable health plan to meet their health needs
- High School / GED (or higher)
- Fluency in Korean and English
- 1+ year of customer service experience
- State Accident and Health Insurance license for New York and New Jersey OR the ability to obtain within 60 days
- Ability to travel between the retail locations to work as needed
- Ability to attend occasional Health Fairs & Community Events
- Prior health and / or general insurance sales experience
- Bilingual in English & Mandarin Chinese
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: UnitedHealth Group, Bergen County, Bilingual, Retail Customer Service Specialist, Health Fairs, Community Events