Research issues and develop customers specific solutions Provide in person Member services to both M&R and DSNP members with their languages at retail store, services including but not limited to Benefits Policies, Procedures, and protocols (pre auth, enrollments, renew rewards, etc.) Claim / billing issues (follow up calls with resolution to identified issues in timely m

Program Administration Collaborates with key university departments (Registrar, Bursar, IT Services, University Communications and Marketing, Health Services. Student Life, etc.) to ensure processes pertaining to the SHIP are as smooth and seamless as possible throughout the insurance plan year. Regularly assesses and facilitates the implementation of the annual online st

Respond to client inquiries and concerns ensuring timely service delivery of excellent customer satisfaction Create and assign work orders to multiple technicians, subcontractors, and/or vendors Effectively communicate work order details with technicians, subcontractors, and/or vendors, and effectively provide up to date reports on work order statuses Experience working w

Coach and motivate agents to achieve or exceed sales targets with a focus on quality and compliance Supervise the daily activities of the team by reviewing and analyzing calls / reports, assessing areas of opportunity, managing work assignments and assuring agents are providing a positive consumer experience Develop staff by providing one on one coaching, conducting role

Assist audit management or audit lead in the execution of internal audits including audit planning, detailing control procedures, and the related testing and reporting in accordance with professional and departmental standards including financial (i.e. Sarbanes Oxley testing) and operational projects Prepare clear, accurate and complete workpapers in accordance with depar

Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently Assist members with adverse determinations, including the appeal process Teach members how to navigate UMR internet based wellness tools and resources Outreach to membership providing pre admission counseling to mem

Determine that the case is assigned to the appropriate team for review (e.g., Medicare, Medicaid, Commercial) Validate that cases/requests for services require additional research Identify and utilize appropriate resources to conduct non clinical research (e.g., benefit documents, evidence of coverage, state/federal mandates, online resources) Prioritize cases based on ap

Identify potential health care business customers Develop business relationships with agents and/or brokers in order to increase sales Promote sales of health care products to small and medium sized businesses (51 300 employees) customers, through brokers. This includes educating and keeping brokers up to date on products and pricing; evaluating and discussing with broker

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Recruits, hires, and manages performance of staff (2 3 employees) providing ongoing feedback, conducting regularly scheduled 1 1s and facilitating the performance management process in a timely manner Leads team pipeline generation, using a curated set of UHG sales tools and prospecting persistence to identify and validate opportunities Guides team members to attain month

Determine that the case is assigned to the appropriate team for review (e.g., Medicare, Medicaid, Commercial) Validate that cases/requests for services require additional research Identify and utilize appropriate resources to conduct non clinical research (e.g., benefit documents, evidence of coverage, state/federal mandates, online resources) Prioritize cases based on ap

Financial management of Lease accounting prepare, document and record lease transactions, including transactions that require technical accounting Fixed asset accounting and asset management close out projects, create assets, maintain appropriate useful life of asset, manage depreciation schedules, evaluate capitalization versus expense A suite of real estate based balanc

With guidance from audit management or audit lead, execute internal audits including audit planning, detailing control procedures, and the related testing and reporting in accordance with professional and departmental standards including financial (Sarbanes Oxley testing) and operational projects Prepare clear, accurate, and complete workpapers in accordance with departme

Full oversight of the specialty sale at the direction of the AE/SAE to achieve health plan market sales goals and maintain profitability Advocate for specialty voluntary products to support increase in enrollment and size of sale and negotiate based on broker/customer feedback with underwriting; leveraging rate bank, product discount programs and packaged savings to lever