Customer Service Representative Senior
About The Position
This position is National Remote. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30 am - 4:00 pm PST. It may be necessary, given the business need, to work occasional overtime. We offer 2 weeks of paid training. The hours of training will be based on your schedule or will be discussed on your first day of employment.
Requirements
- High School Diploma / GED OR equivalent work experience
- Must be 18 years of age OR older
- 1+ years of experience in Medicare and HMO environment
- 1+ years of claims processing OR claims customer service experience
- 1+ years of authorization / referral processing experience
- 1+ years of customer service experience
- Experience with spreadsheet applications such as Microsoft Excel and / OR Microsoft Access
- Experience with and knowledge of standard billing practices
- Experience interpreting provider and health plan contracts
- Experience using Windows programs including Microsoft Word, Microsoft Outlook and Microsoft Excel
- Ability to work full time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30 am - 4:00 pm PST. It may be necessary, given the business need, to work occasional overtime.
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
- Excellent communication and presentation skills
- Good grammar, voice and diction
- Strong organizational and prioritization skills
- Able to represent the company in a professional and positive manner
- Ability to retain composure in stressful situations
- Ability to de-escalate potential volatile situations
- Ability to identify confidentiality and its requirements (HIPAA)
- Strives to be a team player
- Must have excellent, writing, punctuation, grammatical and spelling skills
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Responsibilities
- Occasional shadowing/training of newly hired staff
- Receives and records customer concerns via phone. Acts to resolve concerns in accordance for corporate guidelines and standards for all areas of claims, authorizations and IPA functionality.
- Functions as liaison between physician, health plan, and IPA staff
- Ability to interpret provider and health plan contracts to ensure accurate responses to calls
- Log issues into the Customer Service Tracking database that require resolution and/or follow-up
- Plan and organize workload to ensure efficient and timely resolution of issues.
- Respond to callers with the resolution of issues in a timely manner in accordance with the guidelines set by the department
- Participates in telephonic surveys as required by management
- Follow and support the guidelines set by the department and organization to ensure overall goals are met
- Maintain minimum standards for the department for quality and quantity of calls received
- Foster interpersonal relationships, showing empathy and understanding towards staff, protecting individual self-esteem. Understand own impact on others; interact effectively with peers, subordinates, and supervisors
- Any other assigned duties as delegated by the Customer Service Supervisor
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
