Claims Customer Service Representative

Remote Customer Service Representative

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.

In this role, you'll be empowered to compassionately deliver an exceptional experience to between 30 - 40 callers per day, always remembering that there is a real person on the other end of the phone who is looking for help, guidance, and support. Every phone call gives you that opportunity to improve the lives of our customers and exceed their expectations. You'll spend your day by responding to calls from our members and help answer questions and resolve issues regarding health care eligibility, claims and payments. At the end, you'll know you performed with integrity and delivered the best customer service experience making your customers feel better because they talked to you.

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 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 8 weeks of paid on-the-job training. The hours during training will be 8:00 am - 5:00 pm CST from Monday - Friday. Training will be conducted virtually from your home.

Primary Responsibilities:

• Answer incoming phone calls from customers (i.e., members, providers, facilities) in a call center setting and identify the type of assistance needed (i.e., benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits, and claims information)
• Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller
• Deliver information and answer questions in a positive manner to facilitate strong relationships with members and providers
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Research complex issues across multiple databases and work with support resources to resolve customer issues and / or partner with others to resolve escalated issues
• Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, and attendance

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
• Must be 18 years of age OR older
• 1+ years of experience in a related environment (i.e., call center, customer service, office etc.) using phones and computers as the primary job tools
• Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Ability to successfully complete the Customer Service training classes and demonstrate proficiency of the material
• 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 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Health care experience
• Call center experience

Telecommuting Requirements:

• Reside within the Central Time Zone
• 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:

• Ability to multi - task duties as well as the ability to understand multiple products and multiple levels of benefits within each product
• Demonstrated ability to listen skillfully, collect relevant information, build rapport, and respond to customers in a compassionate manner
• Strong communication skills, empathy
• Critical thinking skills to problem solve and resolve customer concerns

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 $16.15 - $28.80 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.