Correspondence Representative

This position is Onsite. Our office is located at 115 W Wausau Ave., Wausau, WI. UMR, United Healthcare’s third‑party administrator (TPA) solution, is the nation’s largest TPA. When you work with UMR, what you do matters. It’s that simple . . . and it’s that rewarding. In providing consumer‑oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care.

Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record‑breaking growth. Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence.

So, take the first step in what is sure to be a fast‑paced and highly diversified career. This position is full‑time (40 hours / week) Monday – Friday. Employees are required to have flexibility to work any of our 8‑hour shift schedules during our normal business hours of 7:00 AM – 5:00 PM CST. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of paid on‑the‑job training (Number of weeks for training is to be discussed). The hours during training will be 7:00 AM – 5:00 PM from Monday – Friday.

• Provide an exceptional customer service experience when responding to and resolving customer service inquiries and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence.
• Updating information on member files within CPS system (claims processing system, OnBase).
• Research complex issues (such as Medical, Dental, Flex Spending, etc.) across multiple databases and work with support resources to resolve customer issues and / or partner with others to resolve escalated issues.
• Own issue through to resolution on behalf of the member / provider requests that are received.
• Apply creative solutions and effective problem‑solving techniques to address members / provider needs.
• Address complex issues with an awareness of when to refer complicated situations to various departments or leadership for further assistance.
• Searching system for member information variety of systems (example: Explanation of benefits, reviewing call track information, appeals invoicing, check / payment tracking).
• Process medical record payments.
• Manually entering in various types of claims (medical, dental, vision).
• Creating various correspondence to be mailed.
• Running various reports systems.
• Cross train and work in all processes when needed.
• Repetitive movements including siting, stand, kneel, and reaching.
• Other duties as assigned.

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.

• High School Diploma / GED OR 10+ years of equivalent work experience.
• Must be 18 years of age OR older.
• 1+ years of experience with working in an office OR professional setting.
• Ability to navigate a PC to open multiple applications, send emails, conduct data entry, and learn new and complex computer system applications, as well as using dual monitors.
• Proficiency in Microsoft Office Suite – Microsoft Word (ability to create, edit, copy, send, and save documents).
• Proficiency in Microsoft Office Suite – Microsoft Excel (ability to create, edit, copy, send, and save spreadsheets).
• Proficiency in Microsoft Office Suite – Microsoft Outlook (ability to create, edit, copy, send correspondence).
• Ability to work any of our full time (40 hours / week), 8‑hour shift schedules during our normal business hours of 7:00 AM – 5:00 PM CST from Monday – Friday. It may be necessary, given the business need, to work occasional overtime.

• Familiarity with medical terminology, health plan documents, OR benefit plan design.
• Ability to translate…