Health Plans Customer Service Advocate

Overview

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.

EO/AA

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.

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.

• 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.

• 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.

• One year of experience in Customer Service.

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.

Listening, Sitting, Speaking, Standing, Walking

Multi-lingual Candidates Welcomed

University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.

All qualified individuals are encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.

University of Utah Health Hospitals and Clinics, a part of The University of Utah, is an Affiantive Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran's status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106.

The requirement not to discriminate in education programs or activities extends to admission and…