Senior Customer Service Representative

UnitedHealth Group•Tampa, FL

13h•Remote

About The Position

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Senior Customer Service Representative is responsible for providing compassionate and exceptional customer service and issue resolution to our consumers. This role is responsible for handling inbound phone calls from providers under minimal supervision while following policies and procedures to meet department productivity and quality goals. Analysts are responsible for resolving a wide variety of inquiries ranging from routine to moderately complex issues independently, only referring to Team Lead and/or Supervisor as needed. 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 10:35 am – 7:05 pm CST. It may be necessary, given the business need, to work occasional overtime. We offer weeks of paid training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

Requirements

High School Diploma/GED
Must be 18 years OR older
2+ years of experience within the healthcare, claims, or insurance industries.
2+ years of telephonic customer service experience, efficiently handling a high volume of in-bound and/or outbound calls
Proficiency with Microsoft Word, Microsoft Outlook, and Microsoft Excel.
Ability to work an eight-hour shift between Monday- Friday, 07:00AM - 07:00pm CST. Specific shift will be assigned after training.

Nice To Haves

Knowledge of medical terminology

Responsibilities

Assist customers via phone from the Provider Inquiry Line. Incoming calls can be from members and/or Providers questioning claim status, review status, and appeal status.
Provide expertise or general support by reviewing case statuses, researching claims platforms and medical record repositories ultimately analyzing where case is in lifecycle to determine next steps in claim process.
Navigate multiple computer application systems to troubleshoot and resolve inquiries while engaging with the customer and documenting interaction.
Maintains adherence standards of 95%25 or greater.
Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.
Works independently and as part of a team.
Act as a resource for others.
Help internal and external customers by being empathetic, demonstrating patience and good listening skills while providing accurate information.
Manage change in a call center environment, including changes to schedule, business processes and systems/technology.
Assume additional responsibilities as assigned.