Customer Service Representative/CCP - Moline, IL

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards. Primary Responsibilities: Responds to incoming, telephonic, written or email inquiries from customers or providers regarding: Eligibility, benefits, claim status/issues Policies & procedures Reimbursement Claims filing and/or appeals/grievances. Improve the service experience of non-platinum brokers, members, providers and/or customers, thereby enhancing loyalty and retention. Intake, resolution and routing of service requests. Collaborate with UnitedHealth Group's cross-functional experts (e.g., Billing, Eligibility, Claims and Commissions) to resolve issues. Receive, document, confirm, and resolve/route non-platinum broker and customer service issues to the appropriate cross-functional team for resolution. Handle misroutes that come in through the new toll-free phone number. Establish and provide expectations and proactively communicate to non-platinum brokers/customers. Leverage service resources throughout UnitedHealth Group to effectively warm transfer calls to the appropriate area. Approaches difficult situations diplomatically and with a professional demeanor. Actively listens to understand the perspective of others. Proactively identifies and pursues resolution of issues affecting customer service. Meets or exceeds standards for accessibility, responsiveness, reliability and professionalism. Ensures the delivery of excellent customer service. Meets or exceeds standards for productivity, quality, timeliness and accessibility. Make outbound telephone calls and or respond in writing as required to resolve inquiries and issues. Perform in-depth research of inquiries including all follow up and resolution steps. Perform claims adjustments within specified dollar amounts as required to resolve inquiries. Independently manages inquiry caseload to resolve inquiries in a timely, high quality manner. Contributes to high levels of member and client satisfaction by exhibiting timely response to questions or issues, well developed communication skills and analytical approach to problem solving.  Qualifications: High school diploma or equivalent is required. 1 year of customer service experience in a call center environment is required. PC skills (Word/Excel) is required. Medical billing/coding or terminology is highly preferred. Knowledge of FACETS and/or MACESS is a plus. Strong communication skills. Attention to detail. Quality focused. Decision making skills. Organizational skills. Problem solving. Team player. Flexibility in following a schedule provided by the Workforce Manager. Strong customer service orientation. Diversity creates a healthier atmosphere:  equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment.