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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity 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 8:30am - 5:00pm Pacific time. It may be necessary, given the business need, to work occasional overtime.If you are located within the state of CA, you will have the flexibility to work remotely as you take on some tough challenges.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 experience
Must be 18 years of age OR older
1+ years of experience in customer service 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 between 8:30am - 5:00pm Pacific Time including the flexibility to work occasional overtime given the business need
Preferred Qualifications:
1+ years claims processing or claims customer service experience
1+ years of authorization/referral processing experience
2+ years of office experience working within scheduling or training in the medical field setting
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 in stressful situations
Ability to de-escalate potential volatile situations
Ability to understand multiple services and multiple benefit plans for Medicaid
Ability to multi-task
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy California Residents Only: The hourly range for this is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for 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.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.#RPO