Customer Service Agent

As a UnitedHealthcare Customer Service Agent, you will be responsible for assisting members with inquiries related to health insurance coverage, claims, benefits, and provider networks. You will provide support via phone, email, and chat while ensuring compliance with HIPAA regulations and UnitedHealthcare policies.

Responsibilities

• Provide guidance on provider networks, referrals, and pre-authorizations.
• Troubleshoot and resolve issues related to billing, payments, and coverage.
• Ensure compliance with HIPAA regulations when handling sensitive member information.
• Collaborate with internal departments to resolve complex member concerns.
• Maintain accurate records of customer interactions and resolutions in CRM systems.
• Meet performance metrics such as response time, resolution rate, and customer satisfaction scores.
• Stay updated on UnitedHealthcare policies, state regulations, and healthcare industry changes.
  
  

Education

Qualifications

Minimum requirement High School

Preferred Experience

1 year + Customer Service experience in a Call Center

Required Skills

• Previous customer service experience, preferably in healthcare or insurance.
• Strong verbal and written communication skills.
• Ability to handle high call/chat/email volumes effectively.
• Problem-solving skills with the ability to remain calm under pressure.
• Proficiency in computer applications, including CRM and customer support platforms.
• Ability to work flexible shifts, including weekends and holidays.