Key skills
Customer ServiceHealthcare ClaimsCall Center OperationsComputer LiteracyWindows PC ApplicationsMedical Office ExperienceBenefitEligibility KnowledgeBillingPayments KnowledgeAuthorization ProcessesExplanation of Benefits (EOB)
About this role
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, provide support to team members, and build strong relationships to exceed customer expectations.
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 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 any of our full time (40 hours / week), 8-hour shift schedules during our normal business hours of 7:00 am - 8:00 pm CST or MST from Monday - Friday. It may be necessary, given the business need, to work occasional overtime
- Call Center experience
- Health Care experience
- Knowledge of claim / finance and eligibility processes, practices, and concepts