Senior Customer Service Representative

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. As a Senior Customer Service Representative, you'll deliver exceptional experiences to callers and support team members by serving as a resource or subject matter expert.

Responsibilities:

• Serve as a resource for other team members or internal customers
• 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
• Other duties as assigned

Requirements:

• High School Diploma / GED OR equivalent years of working experience
• Must be 18 years of age OR older
• Experience with computers and Windows PC applications, which includes the ability to learn new and complex computer system applications
• All new hires will be required to successfully complete the Customer Service training classes and demonstrate proficiency of the material
• Ability to work full-time (40 hours/week) Monday - Saturday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 11:00 pm EST. It may be necessary, given the business need, it will require to work some holidays. There are peak seasons during which PTO blackout dates apply (First 2 weeks in January and in April). Final shift will be assigned after training
• 1+ years of Customer Service Representative (CSR) experience or 1+ years of experience in an office setting, call center setting or phone support role
• Bilingual fluency in English and Spanish