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UnitedHealth Group

Quality Review Specialist - Minnetonka, MN

UnitedHealth Group - Minnetonka, MN

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Position Description: 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. The Quality Review Specialist monitors adherence to HIPAA and the Centers for Medicareand Medicaid Services (CMS) Guidelines through Quality Monitoring on internal and external Medicare Telesales Agents and Sales Support Representatives. Primary Responsibilities: Monitor agents and representatives for compliance with established processes, policies and guidelines

Provide feedback and coaching to agents and representatives based on evaluation results

Analyze information and utilize to build recommendations to reduce errors and improve process performance

Create and maintain tracking reports in relation to performance

Serve as a subject matter expert resource to team members, supervisors and management staff

Applies knowledge / skills to a range of moderately complex activities

Demonstrates great depth of knowledge / skills in own function

Sometimes acts as a technical resource to others in own function

Proactively identifies solutions to non-standard requests

Solves moderately complex problems on own

Works with team to solve complex problems

Plans, prioritizes, organizes and completes work to meet established objectives

Clear concise communication skills

Works independently

Demonstrates initiative and innovative thinking Qualifications:

Required Qualifications: High School Diploma / GED

2 years of experience in a customer service or Telesales role within a call center

Ability to enter data, save, open, andclose within Microsoft Excel

Ability create documents, save, and close documents within Microsoft Word

Ability send and save emails and be able to use the calendar within Microsoft Outlook

Preferred Qualifications: Associate's Degree (or higher)

Healthcare and / or insurance experience, knowledge of co-pays, co-insurance, and / or deducible

Quality monitoring experience

Medicare insurance experience

Bilingual fluency in English and Spanish (with the ability to read, write and translate in Spanish and English)

Soft Skills: Ability to work independently as well as with others

Ability to work effectively in a fast-paced, changing environment

Physical Requirements and Work Environment: Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer

Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity

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 lifes best work. 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. Keywords:customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, health care, healthcare, office, phone support, training class, customer service advocate, customer service rep, SME, Senior, SR, Quality, Audit





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12 days 12 hours ago

UnitedHealth Group


Quality Review Specialist - Minnetonka, MN UnitedHealth Group - Minnetonka, MN, United States


Location: Minnetonka, MN

Company Profile:
About UnitedHealth Group UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone. We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term