Senior Customer Service Representative

UnitedHealth Group•Los Angeles, CA

11h•$18 - $32•Remote

About The Position

This position is Remote in California. You will have the flexibility to work remotely 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 (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 7:30 am - 4:30 pm PST. It may be necessary, given the business need, to work occasional overtime. We offer 2 - 4 weeks of paid training. The hours of training will be based on your schedule or will be discussed on your first day of employment. 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.

Requirements

High School Diploma / GED or equivalent work experience
Must be 18 years of age OR older
1+ years of customer service experience
Experience with spreadsheet applications such as Excel and/or Access
Experience using Windows programs including Microsoft word, Outlook and Excel
Ability to work 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 7:30 am - 4:30 pm PST. It may be necessary, given the business need, to work occasional overtime
Reside within the state of California.
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.
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Nice To Haves

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
Experience with and knowledge of standard billing practices
Experience interpreting provider and health plan contracts

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