Senior Customer Service Representative

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. In this role, you will deliver exceptional customer service to callers, assist team members, and build strong relationships while addressing healthcare inquiries and claims.

Responsibilities:

• Review and research incoming healthcare claim calls from providers (doctors, clinics, etc.) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Communicate and collaborate with providers to resolve issues, using clear, simple language to ensure understanding
• Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality and attendance
• Answer incoming phone calls from members 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)

Requirements:

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 6+ months of work at home experience
• 6+ months of Customer Service Representative (CSR) experience OR 1+ years of experience in a medical / standard office setting, call center setting or phone support role
• Working knowledge with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Ability to work full time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 8:00 pm CST. It may be necessary, given the business need, to work occasional overtime and no weekends
• Call Center experience
• Health Care experience
• Knowledge of billing / finance and eligibility processes, practices, and concepts