Senior Customer Service Representative

Optum is dedicated to improving the flow of health data and information to create a more connected system. As a Senior Customer Service Representative, you will deliver exceptional service to callers, resolve complex issues, and support team members while ensuring a positive customer experience.

Responsibilities:

• Handle escalated calls, resolving more complex customer issues in a one and done manner
• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Intervene with care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
• Assist customers in navigating UnitedHealth Group websites and encourage and reassure them to become self-sufficient
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
• Provide education and status on previously submitted pre-authorizations or pre-determination requests
• Meet the performance goals established for the position in the areas of: efficiency, call quality, provider satisfaction, first call resolution and attendance

Requirements:

• High School Diploma / GED
• Must be 18 years of age OR older
• 1+ years of healthcare customer service experience
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• 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 8:00am - 5:00pm EST
• 1+ years of Customer Service Representative (CSR) experience OR 1+ years of experience in an office setting, call center setting or phone support role
• Medical terminology experience
• Knowledge of billing/finance and eligibility processes, practices, and concepts
• Proficient in translating health care-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon