Plan Advisor - Remote in Oklahoma
About the position
As a Plan Advisor for UMR, UnitedHealthcare's third-party administrator (TPA) solution, you will play a crucial role in providing consumer-oriented health benefit plans to millions of people. Your primary responsibility will be to deliver exceptional customer service while assisting members with their healthcare needs. This position allows you to work from home if you are located within Oklahoma City, OK, providing you with the flexibility to manage your work-life balance while tackling challenging tasks. You will be empowered to make a significant impact on the lives of our members and their families by acting as their trusted advisor and advocate. Your role will involve helping members understand their care services, answering their questions, resolving outstanding issues, scheduling appointments, and assisting them in enrolling in or selecting a healthcare plan. In this position, you will handle a high volume of calls, typically between 50-70 per shift, while maintaining a compassionate and engaging demeanor to enhance the customer experience. In addition to call handling, you will also process medical claims after completing the necessary training. A solid understanding of medical benefits and terminology will be essential for effectively assisting with claims processing. The role follows a structured daily schedule, with key performance metrics including units per hour, call handling, and attendance. You will be expected to work full-time, 40 hours per week, Monday through Friday, with flexibility to work any of the 8-hour shift schedules during our normal business hours of 7:00 AM - 8:00 PM CST. Occasionally, you may be required to work overtime based on business needs. You will receive comprehensive training, lasting up to 10 weeks, to ensure you are well-prepared for your responsibilities. Training will be conducted virtually, and 100% attendance is mandatory. Throughout your career at UMR, you will have opportunities for professional development and advancement, supported by a culture that values your contributions and encourages your growth.
Responsibilities
Provide an exceptional customer service experience when responding to and resolving customer service inquiries and issues.
,
Research complex issues across multiple databases and work with support resources to resolve customer issues.
,
Own issues through to resolution on behalf of the member in real time or through comprehensive follow-up.
,
Apply creative solutions and effective problem-solving techniques to address members' needs.
,
Educate members on health incentives offered by their employer and consumer-driven health products.
,
Educate callers on the benefits of a primary care physician and preventive screenings.
,
Intervene with care providers on behalf of the member to assist with appointment scheduling.
,
Address complex issues and refer complicated situations to various departments or leadership for further assistance.
,
Translate healthcare-related terms into simple, step-by-step instructions for members.
Requirements
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.
,
Ability to successfully complete the training classes and demonstrate proficiency of the material.
,
Ability to ensure uninterrupted work time while on shift.
Nice-to-haves
Familiarity with medical or dental terminology, health plan documents, or benefit plan design.
,
Prior experience with utilizing multiple systems/platforms while on a call with a member.
Benefits
Flexible telecommuting options for employees located in Oklahoma City, OK.
,
Comprehensive training program lasting up to 10 weeks with 100% attendance required.
,
Opportunities for career development and advancement within UMR.
Apply Job!