UNITED EHALTHCARE GROUP
(Customer Service Representative)
Managing incoming calls from patients and making outbound calls if necessary.
Check if the patient's insurance is active.
Help patients understand their health plan benefits.
Answer basic questions about claims and billing.
Assist patients in finding in-network providers and scheduling appointments.
Explain complex information and Assisting patients with filing grievances
Tools: Avaya, RxClaim, Citrix, Jacada Portals: UHC Portal
OPTUM GLOBAL SOLUTIONS
(Customer Service Representative)
Manage incoming patient calls and initiate outbound calls as needed.
Verify the patient's insurance status.
Provide assistance in understanding health plan benefits.
Address general inquiries regarding claims and billing.
Support patients in locating in-network providers and scheduling appointments.
Process monthly premium payments for members.
Tools: Avaya,RxClaim, Citrix, Jacada Portals: UHC Portal
UMR - UNITED HEALTCARE GROUP
(Intake Specialist)
Managing incoming calls from providers' offices, facilities, hospitals, and other healthcare
providers.
Making outbound calls when necessary.
Verifying whether prior authorization is required and recommending predetermination when applicable.
Initiating a case as needed. Monitoring the status of cases.
Providing the rationale for case denials and instructions on how to make peer-to-peerrequests.Offering information for appeals and tracking the status of appeal requests.
Tools: Avaya, RxClaim, Aerial, Jacada