Health Plans Customer Service Advocate

Customer Service Representative

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission.

This position for use in Health Plans Departments only. The Customer Service position is responsible for providing world class customer service to our members and providers by demonstrating empathy, advocacy and expertise. This position answers phone inquiries in a call center environment, while optimizing accuracy of information, service and quality. The incumbent seeks to optimize the member and provider experience by offering one call resolution by being experts in benefits and eligibility. This position is not responsible for providing care to patients.

Corporate Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system.

Responsibilities

Essential Functions

• Supports and promotes UUHP's mission, vision, values, and goals.
• Contributes to positive and productive team environment.
• Maintains accountability for customer service performance expectations.
• Explains adjudication of claims for allocation of deductibles, co-pays, co-insurance maximums and provider reimbursements.
• Provides prompt customer service to members, providers, billing departments and other insurance companies regarding claims, benefits and eligibility, provider network status, and any other related insurance inquiries.
• Documents phone calls in system and follows up on issues if needed.
• Resolves problems resulting from claim adjudication and customer service phone calls.
• May monitor and answer customer service inquires via email.

Knowledge / Skills / Abilities

• Ability to perform the essential functions of the job as outlined above.
• Demonstrated skills in customer service.
• Ability to work effectively, independently, and as part of a team.
• Strong organization, time management and project management skills and multi-tasking abilities.
• Detail oriented with problem-solving abilities.
• Demonstrated strong communication skills.
• Demonstrated strong computer competency in navigating multiple programs and resources as well as typing.

Qualifications

Required

• One year of experience in Customer Service.

Qualifications (Preferred)

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Listening, Sitting, Speaking, Standing, Walking