Job Category:

Call Center, Customer Service, Medical & Health, Medical Billing


Pay:

To be discussed.


Overview

UCare is proud to be a recognized Star Tribune Top Workplace for the 7th consecutive year. As a part of our collaborative team, you’ll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual’s ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you’re looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply.

Preferred Experience

Working knowledge of medical claims and/or medical billing processes is preferred. Proficient computer skills; knowledge of Microsoft office, Amisys, and MACESS type software packages.

Required Experience

One to two years call center experience or two years customer service experience. Preference given to candidates with health insurance (HMO), physician group practice, or community agency. Proficient PC skills required knowledge of Microsoft office preferred.

Education

High school graduate or the equivalent required. Two-year degree in health related, liberal arts or communication field, including a course in medical terminology is preferred.

Position Description

* Under general supervision, responsible for accurately applying knowledge of UCare’s business, products, members and operations to effectively fulfill member service requests and inquiries. Ensure adherence to all policies and procedures and meet/exceed service levels by following established guidelines and standards. Achieve fluency in at least one core product or service line.

* Answer, resolve, track and document telephone calls from members, providers, internal departments, and external agencies, in a timely and professional manner. Research, resolve and communicate effectively with internal and external customers regarding member/provider concerns or issues. Educate members and external customers on policies and procedures related to members’ health care program.

* Research and resolve inquiries from internal /external customers including: Enrollment, eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims, payments, member reimbursement, and demonstrated knowledge of CAG policies, procedures, and regulations. Utilize appropriate resources to respond to member inquiries.

* Answer, resolve, track and document telephone calls from members and providers in a timely and professional manner. Interpret member eligibility and coverage through thorough knowledge of the contracts, policies and procedures. Communicate with internal departments, members, providers and other customers regarding the transportation benefit in both verbal and written form, including faxing rides to providers at the appropriate times.

* Identify trends/issues that emerge in calls/correspondence, and inform Team Lead or Supervisor. Assist in the development and communication of resolutions to internal staff, as requested.

* Demonstrate and maintain a thorough and complete working knowledge of appropriate UCare information management systems, and ACD telephone system.

* Maintain good working relationships and open communication with internal and external customers.

* Attend department and other meetings as requested.

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