Senior Customer Service Representative

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Senior Customer Service Representative will play an advanced role in providing superior access for patients and will serve as a resource and mentor for lower level representatives, handling complex issues and ensuring extraordinary customer service.

Responsibilities:

• Maintains a higher degree of technical expertise than Patient Services Representative I and serves as role model to Patient Services Representative I's. Able to problem-solve and serve as a resource to other Patient Services Representatives
• Screens all incoming patient inquires (through phone, online/medical record message, or other means) to determine whether those inquiries can be appropriately handled by the Patient Service Representative or if they need to be directed to other team members
• Courteous, friendly, problem solver with customer service, patient focused communication. Acts as a role model for other support staff and demonstrates a high level of competency in Patient Service Representative responsibilities
• Proactively identifies issues and works to resolve them in areas involving patient satisfaction, patient flow, and compliance with procedures and guidelines. Advocates for patients as appropriate
• Identifies and assists in resolving operational difficulties and communicates with supervisor regarding department issues and problems as necessary. Demonstrates a high level of competency when handling difficult phone calls and dealing with complex issues
• Initiates request for forms, letters, medication renewals, referrals, prior authorizations, and any other administrative needs submitted by patients and answers any corresponding questions. Understands all documents and processes
• Reviews and facilitates the updating of missing /outdated information in the patient record, such as demographics, primary care physician selection, and insurance
• Develop and maintain effective and efficient communication with the patient, interdisciplinary team, department staff, providers, and other agencies
• Reviews department appointment schedules to ensure that clinic utilization is optimized and effectively supports the needs of the clinics as well as the needs of the patients
• Assists with data collection activities and provide appropriate follow up for statistical reports or required studies, ensuring data is properly collected and accurate (e.g. no show reports, telephone statistics)
• Receives escalated issues and determines appropriate action and/or works with clinical team for decision
• Effectively deescalates issues with upset patients and practices. Uses advanced listening techniques to understand the issue and give patients options as they are available. Escalates to supervisors only as needed
• Supports, mentors and trains lower level assistants
• Participates in problem solving activities, focusing on productivity and quality. Works with supervisors to ensure continuous improvement of the department
• Participates in special projects and ongoing programs unique to the department
• May represent department on groups and teams related to upgrades of the electronic medical record
• Performs functions of a Patient Service Representative I

Requirements:

• HS Diploma/GED OR equivalent work experience
• Must be 18 years of age OR older
• 3+ years of experience in a clinical or customer service setting
• Proficient in Microsoft Office programs
• Flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:30 pm -8:00 am
• Reside within the EST 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
• Able to communicate in a professional and appropriate manner
• Strong interpersonal skills
• Strong time management skills
• Ample organizational skills
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
• Experience with EPIC
• Experience working overnight
• Working knowledge of patient related documents preferred
• Call center experience
• Reside within Massachusetts