Senior Customer Service Representative

Senior Customer Service Representative

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.

The Senior Customer Service Representative is:

• Responsible for representing the organization and functioning as a key communicator for the organizations providers.
• Educates and informs customers of organizations programs and services.
• Promotes company's commitment to superior customer service.
• Proactively and reactively seeks appropriate solutions to potential and existing service issues.
• Identifies root cause issues and works diligently and cooperatively to minimize or eliminate issues.

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 weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

Primary 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.

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.

Required Qualifications:

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 1+ years of experience in customer service role in a medical environment
• 1+ years of experience in Medicare and HMO environment
• Ability to identify confidentiality and its requirements (HIPAA)
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Ability to type 40 - 50 words per minute
• 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

Preferred Qualifications:

• 2+ years of office experience working within scheduling or training in the 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

Telecommuting Requirements:

• 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.

Soft Skills:

• Strong organizational skills
• Excellent communication and presentation skills
• Good grammar, voice and diction
• Ability to retain composure

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.