Senior Customer Service Representative 2376056 | Dallas, TX | Remote

Senior Customer Service Representative

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 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.

Primary 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% 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.

Required Qualifications:

• High School Diploma / GED
• Must be 18 years of age 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

Preferred Qualifications:

• Knowledge of medical terminology

Telecommuting Requirements:

• 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

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). The hourly pay for this role will range from $18 - $32 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.