Svs Escl Acct Mgr . Contact Center Operation
UnitedHealthcare Optum Division
Atlanta, Georgia
04.2020 - Current
- Leveraged leadership skills to identify deficiencies and opportunities to improve policies, procedures and controls.
- Analyzed customer feedback data to develop action plans for improving services offered.
- Collaborated with other departments to ensure timely completion of projects within budget constraints.
- Enhanced team member performance through use of strategic and tactical approaches, motivational coaching and training.
- Recruited and trained new employees to meet job requirements. care management, program coordination, patient care, Medicare Retirement Service
- Maintained up-to-date records of employee attendance, payroll information, vacation requests. long-term disability, short-term disability inquiries, complaints requiring management-level escalation primary responsibilities enterprise clinical service
- Handle call transfers for claims reconsiderations and member education. Contact care providers (doctor’s offices) on behalf of the customer to assist
- Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to select the best benefit plan options, maximize the value of their health plan benefits and choose a quality care provider
- Assist customers in navigating UnitedHealth Group websites, encouraging and reassuring them to become self-sufficient in using our tools
- Act as a Subject Matter Expert or mentor to other team members
- Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims
- This is a challenging role that takes an ability to thoroughly review, analyze and research complex healthcare claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You’ll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will support timely processing of the member's claim.
