Customer Service Specialist

Customer Service Representative

This position is national remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

UMR, UnitedHealthcare's third-party administrator (TPA) solution, is the nation's largest TPA. When you work with UMR, what you do matters. It's that simple and it's that rewarding.

In providing consumer-oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth.

Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast-paced and highly diversified career.

Our Customer Service Representatives play a vital role in UMR's success by supporting members and providers while delivering exceptional service experiences. As a key point of contact, you'll help answer questions, navigate complex situations, build trust, and create positive outcomes. No two days are the same, and every interaction is an opportunity to make a meaningful impact.

Through comprehensive training, ongoing support, and continuous learning opportunities, you'll gain valuable healthcare industry knowledge and develop skills that can support long-term career growth. Whether your focus is supporting providers, assisting members, researching complex issues, or developing new skills in healthcare operations, you'll be part of a team that values collaboration, innovation, and service excellence.

If you're passionate about helping others, enjoy solving problems, and thrive in a fast-paced environment, this is an exciting opportunity to launch or grow your career with a company committed to helping people live healthier lives.

This position is full time (40 hours/week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 8:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer an initial 9 - 10 weeks of paid training. The hours during training will be 8:00 am - 4:30 pm CST, Monday - Friday. Training will be conducted virtually from your home and attendance during training is 100% mandatory.

Primary Responsibilities:

• Serve as a trusted resource by providing exceptional service and support to members and/or providers
• Answer incoming inquiries and determine the appropriate assistance needed
• Listen actively, ask thoughtful questions, and accurately document information in multiple systems
• Research and resolve questions, concerns, and issues through real-time problem-solving and follow-up
• Navigate multiple applications and resources to gather information and resolve inquiries efficiently
• Communicate complex information in a clear, simple, and easy-to-understand manner
• Collaborate with teammates and business partners to deliver effective solutions and positive outcomes
• Meet established goals related to quality, productivity, customer satisfaction, accuracy, and attendance
• Continuously learn and apply new skills, processes, and industry knowledge to support success

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
• Must be 18 years of age OR older
• 1+ years of customer service experience in an office OR professional setting
• Experience with using computers as primary work tool
• This position will receive 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 successfully complete the Customer Service training classes and demonstrate proficiency of the material
• Flexibility to work any of our full time (40 hours/week), 8-hour shift schedules during our normal business hours of 7:00 am - 8:00 pm CST, Monday - Friday

Preferred Qualifications:

• Customer service call center experience
• Experience in a healthcare, insurance, medical, OR dental environment
• Experience with researching OR processing healthcare claims
• Experience with navigating multiple systems while assisting customers
• Familiarity with medical and/OR dental terminology, claims processing, coding, benefit plans, and health plan documents

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 (UHG requires a wired internet connection: cable, DSL or fiber internet service with Minimum speed standard of 25 Mb download/10-15 Mb upload. Wireless services such as satellite, hot spot, line of sight antenna cannot be used for telecommuting.)

Soft Skills:

• Demonstrated commitment to delivering exceptional service experiences
• Communicates with empathy, professionalism, and authenticity to create positive interactions
• Uses thoughtful listening and effective questioning techniques to understand and address customer needs
• Applies resourcefulness and sound judgment to identify solutions and navigate complex situations
• Handles sensitive and difficult situations with composure, respect, and a focus on resolution
• Maintains a high level of accuracy and attention while managing multiple priorities
• Effectively utilizes technology and digital tools to support customers and achieve business goals
• Adapts quickly to changing priorities, new information, and evolving customer needs
• Embraces continuous learning, professional growth, and opportunities to expand skills and knowledge
• Contributes to a culture of collaboration, inclusion, and customer-first excellence

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18 - $32 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.