Senior Customer Service Representative

UnitedHealth Group•Tampa, FL

4d•$18 - $32•Remote

About The Position

The Senior Customer Service Representative represents the organization and serves as a key communicator for its providers. The role educates customers about the organization’s programs and services, promotes superior customer service, and proactively and reactively resolves potential and existing service issues. The representative identifies root causes and works cooperatively to minimize or eliminate issues. This is a national remote, full-time position with a Monday–Friday schedule. Employees must be flexible to work any eight-hour shift during normal business hours of 7:30 a.m. to 4:00 p.m. PST. Occasional overtime may be necessary. The role includes on-the-job training, with training hours based on the schedule or discussed on the first day of employment. The representative receives and records customer concerns by phone; addresses concerns related to claims, authorizations, and IPA functionality in accordance with corporate guidelines; and serves as a liaison among physicians, health plans, and IPA staff. The position also involves interpreting provider and health plan contracts, documenting issues requiring resolution or follow-up, organizing work to resolve issues efficiently, and communicating resolutions promptly. Other duties include occasional shadowing or training of new staff, participating in telephonic surveys as required, meeting department quality and call-volume standards, following departmental and organizational guidelines, maintaining effective interpersonal relationships, and completing duties delegated by the Customer Service Supervisor. Remote employees must secure sensitive company documents when applicable, maintain a dedicated private work area separate from other living areas, and live where they can obtain an approved high-speed internet connection or use existing high-speed internet service. Remote employees must follow UnitedHealth Group’s Telecommuter Policy.

Requirements

High school diploma/GED or equivalent work experience.
Must be at least 18 years old.
Familiarity with computers and Windows PC applications, including the ability to learn new and complex computer system applications.
Ability to type 40–50 words per minute.
Ability to work full-time Monday through Friday and be flexible to work any eight-hour shift during normal business hours of 7:30 a.m. to 4:00 p.m. PST; occasional overtime may be necessary.
Ability to secure sensitive company documents when applicable.
Ability to maintain a dedicated work area separated from other living areas that provides information privacy.
Must live in a location that can receive a UnitedHealth Group-approved high-speed internet connection or have existing high-speed internet service.
Ability to adhere to UnitedHealth Group’s Telecommuter Policy when working remotely.
Strong organizational skills.
Excellent communication and presentation skills.
Good grammar, voice, and diction.
Ability to retain composure.
Must pass a drug test before beginning employment.

Nice To Haves

2+ years of office experience working in scheduling or training in a medical field setting.
1+ years of claims processing or claims customer service experience.
1+ years of authorization/referral processing experience.
Knowledge of standard billing practices.
Ability to interpret provider and health plan contracts.

Responsibilities

Occasionally shadow or train newly hired staff.
Receive and record customer concerns by phone and resolve concerns in accordance with corporate guidelines and standards for claims, authorizations, and IPA functionality.
Serve as a liaison between physicians, health plans, and IPA staff.
Interpret provider and health plan contracts to provide accurate responses to calls.
Log issues requiring resolution or follow-up in the Customer Service Tracking database.
Plan and organize workload to ensure efficient and timely issue resolution.
Respond to callers with resolutions in a timely manner and in accordance with departmental guidelines.
Participate in telephonic surveys as required by management.
Follow and support departmental and organizational guidelines to help meet overall goals.
Maintain department minimum standards for the quality and quantity of calls received.
Foster effective interpersonal relationships and demonstrate empathy and understanding toward staff; interact effectively with peers, subordinates, and supervisors.
Perform other duties delegated by the Customer Service Supervisor.