Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

As a Customer Service Representative, we are responsible for acting as a patient advocate to help resolve patient issues pertaining to claims, benefits referrals, physicians and access. Assists with patient education and ensures that required services are delivered to patients. Serves as a liaison between the patient and other departments and Optum sites. Assists other Representatives and Supervisors with daily workload as needed to resolve and/or document patient issues.

This position is full-time (40 hours/week), Monday - Friday. Employees are required to have flexibility to work an 8-hour shift schedule during our normal business hours of 8:00am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime and have flexibility to rotate shifts including weekends and holidays.

We offer 2-3 weeks of paid on-the-job training. The hours during training will be 8:00am - 5:00pm PST, Monday - Friday. Training will be conducted virtually from your home.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Applies knowledge/skills to activities that often vary from day to day
Assist member and answer any questions they have
Answering an average of 50 calls per shift
Demonstrates a moderate level of knowledge and skills in own function
Requires little assistance with standard and non-standard requests
Solves routine problems on own
Works with supervisor to solve more complex problems
Prioritizes and organizes own work to meet agreed upon deadlines
Works with others as part of a team
Demonstrate understanding of internal/external factors that may drive caller questions/issues (e.g., recent plan changes, mass mailings, call directing/rerouting, weather emergencies)
Ask appropriate questions and listen actively to identify underlying questions/issues (e.g., root cause analysis)
Gather appropriate data/information and perform initial investigation to determine scope and depth of question/issue
Identify and coordinate internal resources across multiple departments to address client situations, and escalate to appropriate resources as needed
Proactively contact external resources as needed to address caller questions/issues (e.g., providers, labs, brokers)
Utilize appropriate knowledge resources to drive resolution of applicable questions/issues (e.g., websites, CRM tools, Onyx, Siebel, knowledge bases, product manuals, SharePoint)
Identify and communicate steps/solutions to caller questions/issues, using appropriate problem-solving skills and established guidelines, where available (e.g., workarounds, descriptions of relevant processes)
Offer additional options to provide solutions/positive outcomes for callers (e.g., online access to relevant information, additional plan benefits, workarounds for prescription delays)
Make outbound calls to resolve caller questions/issues (e.g., to callers, providers, brokers, pharmacies)
Drive resolution of caller questions/issues on the first call whenever possible (e.g., first-call resolution, one-and-done)
Ensure proper documentation of caller questions/issues (e.g., research conducted, steps required, final resolution)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

High School Diploma / GED OR equivalent work experience
Must be 18 years of age OR older
2+ years of customer service experience in a healthcare, medical office and / OR Medical Insurance company
2+ years of experience using an Electronic Medical Records system
1+ years of experience using a multi-line telephone
Ability to work an 8-hour shift schedule during our normal business hours of 8:00am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime and have flexibility to rotate shifts including weekends and holidays

Preferred Qualifications:

Bilingual fluency in English and any of the following languages: Spanish, Farsi, Tagalog, Vietnamese, Mandarin and Korean
Experience working in EPIC system

Telecommuting Requirements:

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

Soft Skills:

Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner
Proficient conflict management skills to resolve issues in a stressful situation

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The hourly range for this role is $16.00 to $28.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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