Senior Customer Service Representative - Remote In Ca

If you are located within the state of California, you will have the flexibility to telecommute* (work from home) 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 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 work our normal business hours of 8:30 AM - 5:00 PM PST (Pacific Standard Time). It may be necessary, given the business need, to work occasional overtime.

• All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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
• 1+ years of experience with Customer Service in a medical environment
• 1+ years of experience in a Medicare and HMO environment
• Ability to identify confidentiality and its requirements (HIPAA)
• Familiarity with using computer and Windows personal computer applications, which includes the ability to learn new and complex computer system applications
• Ability to type at the speed of 40+ WPM (words per minute)
• Ability to work any shift between the hours of 8:30 AM - 5:00 PM PST (Pacific Standard Time) from Monday - Friday
• Must be 18 years of age OR older

Preferred Qualifications:

• 2+ years of office experience with 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 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

California Residents Only: The hourly range for California residents is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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.

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