Job Location: Dallas, TX
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life’s best work.SM
The Agent Complaint Tracking Analyst will receive agent complaints from the Centers for Medicare and Medicaid Services (CMS), regulatory or UHC internal sources. Responsibilities include upload and set up of agent complaint records within a database; analyzing agent complaints for validity; analyzing the complaint to assign the correct complaint allegation(s); and utilization of multiple internal resource tools to recommend a proper disposition of complaints. Assigns corrective actions within a case management tool, utilizing documented hierarchies. Utilizes pertinent investigation data and uses own judgment as well as decision job aids to perform audits of all completed corrective actions to determine proper outcome. Utilizes reporting to follow up on overdue corrective actions. Performs calls to UHC members whose enrollment showed on a Suspicious Enrollment report, utilizing an approved script.
This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime.
- All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Assign corrective actions from a case management tool utilizing an assignment crosswalk.
- Reconcile remediation module assignments
- Monitor completion of Complaint Education Contact (CEC) and Corrective Action Response (CAR) outreach coaching requests, and escalate incomplete assignments
- Analyze/audit coaching request coaching notes (notes document the agent’s required training after corrective action has been assigned following a complaint’s investigation) for quality and provide feedback for improvement.
- Utilizes an approved script to call members who have enrolled via UHC’s public web portal, to determine compliant application processes. Records findings within a case management tool
- Acts as backup for the Agent Compliance Tracking Consultant, or Department of Insurance Consultant
- Assist with the creation of CMS requested agent files
- Subject Matter Expert – Acts as a resource for others with less experience
- Receive, triage, and process, and incoming agent complaints
- Respond to CMS requests for information around agent complaints
- Assists with responses to State Departments of Insurance (DOI) requests for information around agent complaints
- Perform other related duties as required to achieve the goals and objectives of the company and department
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 (or higher)
- 1+ years of experience in the healthcare, insurance, or financial services industry
- 6+ months of telephonic customer service experience
- Microsoft Office including Microsoft Word (create correspondence and work within templates), Microsoft Excel (ability to sort, filter, and create simple spreadsheets
- Ability to work full-time between 8:00am – 5:00pm
Preferred Qualifications:
- Associates Degree (or higher)
- 6+ months of experience working in a regulated industry
- 6+ months of auditing or second level review experience
- 6+ months of experience working with Medicare and Retirement (M&R) plans, summaries of benefits and explanation of coverage as it relates to M&R insurance plans
- Experience working with multiple system platforms
- Knowledge of insurance industry, compliance, licensing or claims experience
- Knowledge of GPS, iLead, MIRA, ODM, ICM, SMRT, PCL, ImageRight, OnBase, and Learning Lab
- Experience working with Centers for Medicare and Medicaid Services (CMS) Guidelines
Telecommuting Requirements:
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Ability to keep all company sensitive documents secure (if applicable)
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
- Communication, and interpersonal skills; able to work with team members and all levels within the organization.
- Analytical/problem solving skills
- Able to work independently, with minimal supervision: self-starter
- Hard work, honesty, integrity, and unwavering business ethics
- Ability to multi-task and balance own workload
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military
Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet
Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in healthcare. And we are the largest business in the nation dedicated to serving their unique health and well – being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You’ll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our Healthcare system. Ready? It’s time to do your life’s best work.SM
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $18.17 – $32.26. The salary range for Connecticut / Nevada residents is $20.00 – $35.53. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.
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