This position is Onsite. Our office is located at 115 W WAUSAU AVE. Wausau, WI.
UMR, UnitedHealthcare's third-party administrator (TPA) solution, is the nation's largest TPA. When you work with UMR, what you do matters. It's that simple . . . and it's that rewarding.
In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth.
Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast - paced and highly diversified career.
Put it all together - a highly competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success.
Some of our offerings include:
- 18 days of Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement - up to $5,250 per calendar year for job-related coursework
- Adoption Assistance Plan
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
- On-site Fitness facility
- More information can be downloaded at: Health insurance plans | UnitedHealthcare
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 (7:00am - 5:00pm CST). It may be necessary, given the business need, to work occasional overtime.
Primary Responsibilities
- Provide an exceptional customer service experience by responding to and resolving customer inquiries and issues, identifying the topic and type of assistance needed, including benefits, eligibility and claims, financial spending accounts, and correspondence.
- Update member information within CPS systems, including claims processing systems and OnBase.
- Research complex issues related to Medical, Dental, Flexible Spending Accounts, Pharmacy, and other benefit areas across multiple databases, and collaborate with support resources to resolve customer issues or escalated concerns.
- Own customer and provider issues through resolution on behalf of the member or provider.
- Apply creative solutions and effective problem-solving techniques to address member and provider needs.
- Address complex issues and determine when to escalate situations to appropriate departments or leadership for additional support.
- Search multiple systems to obtain member information, including explanations of benefits, call tracking details, appeals, invoicing, and check/payment tracking.
- Process medical record payments.
- Enter various types of claims manually, including medical, dental, and orthodontic claims.
- Create correspondence for mailing.
- Run reports across various systems.
- Cross-train and support all operational processes as needed
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
- Must be 18 years of age OR older
- 1+ years of experience working in an office or professional setting
- Capacity to navigate a PC to open multiple applications, send emails, conduct data entry, and learn new and complex computer system applications, as well as using dual monitors
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook)
- Must be able to work onsite at 115 W WAUSAU AVE. Wausau, WI
- Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 5:00pm CST. It may be necessary, given the business need, to work occasional overtime
Preferred Qualifications
- Experience Translating healthcare-related terms or terminology processes into simple, step-by-step instructions which members can understand
- Experience remaining focused and productive each day while completing tasks that may be repetitive
- Experience managing multiple priorities and understanding a wide range of products and their associated benefit levels
- Familiarity with medical terminology, health plan documents, or benefit plan design
- Active listening skills, quickly build rapport, and respond to customers with compassion by gathering relevant information, identifying immediate and future needs, and consistently exceeding expectations through respectful, timely service and reliable follow-through on commitments
Soft Skills
- Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrate personal resilience
- Proficient problem-solving approach to quickly assess current state and formulate recommendations
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18 - $32 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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