Plan Advisor Representative

Primary Responsibilities:

Provide an exceptional customer service experience when responding to and resolving 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
Research complex issues (such as Medical, Dental, Flex Spending, Pharmacy, etc.) across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
Own issue through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
Apply creative solutions and effective problem solving techniques to address members’ needs
Educate the member on health incentives offered by their employer as well as consumer driven health products; HSA, HRA, and HDHP – some resulting in additional healthcare dollars for the member to utilize
Educate the caller on the benefits of a primary care physician and help to ensure / educate that all preventive screenings have been completed
Intervene with care providers (doctor’s offices) on behalf of the member to assist with appointment scheduling or other matters when needed
Address complex issues with an awareness of when to refer complicated situations to various departments or leadership for further assistance
Translate healthcare – related terms or terminology and complex processes into simple, step – by – step instructions which members can understand

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 10+ years of equivalent work experience
Must be 18 years of age OR older
1+ years of customer service experience in an office OR professional setting
This position will receive member calls up to 50 – 70 calls daily and requires full attention to work duties. Employees in this role must ensure they will have uninterrupted work time while they are on shift (outside of normally scheduled breaks and lunch)
Capability to participate in training classes and demonstrate understanding of the material, with OR without reasonable accommodation
Flexibility to work any of our full time (40 hours / week), 8-hour shift schedules during our normal business hours of 7:00 AM – 7:00 PM CST from Monday – Friday. It may be necessary, given the business need, to work occasional / voluntary overtime

Preferred Qualifications:

Familiarity with medical OR dental terminology, health plan documents, OR benefit plan design
Experience with utilizing multiple systems / platforms while on a call with a member

Telecommuting Requirements:

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

Soft Skills:

Experience using a computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
Capability to quickly build rapport and respond to customers compassionately by identifying and exceeding their expectations (responding respectfully, timely, and consistently meeting commitments), with or without reasonable accommodations
Capability to listen skillfully, gather relevant information, determine immediate requests, and identify the current and future needs of the member, with or without reasonable accommodations
Flexibility to customize approach to meet all types of member communication styles and personalities
Proficient problem solving approach to quickly assess current state and formulate recommendations
Proficient conflict management skills, including the capability to resolve issues in stressful situations and demonstrate personal resilience, with or without reasonable accommodations
Capability to manage multiple tasks and comprehend various products and their respective benefit levels, with or without reasonable accommodations