UnitedHealth Group
Senior Customer Service Representative
UnitedHealth Group, Sacramento, California, United States, 95828
Overview
This position is Remote in California. You will have the flexibility to work remotely as you take on some tough challenges.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need. Here you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during normal business hours 7:30 am – 4:00 pm PST. It may be necessary, given the business need, to work occasional overtime.
We offer 2 weeks of paid training. The hours of training will be based on your schedule or will be discussed on your first day of employment.
Primary Responsibilities
Occasional shadowing / training of newly hired staff
Receives and records customer concerns via phone. Acts to resolve concerns in accordance for corporate guidelines and standards for all areas of claims, authorizations and IPA functionality
Functions as liaison between physician, health plan, and IPA staff
Ability to interpret provider and health plan contracts to ensure accurate responses to calls
Log issues into the Customer Service Tracking database that require resolution and/or follow‑up
Plan and organize workload to ensure efficient and timely resolution of issues
Respond to callers with the resolution of issues in a timely manner in accordance with the guidelines set by the department
Participates in telephonic surveys as required by management
Follow and support the guidelines set by the department and organization to ensure overall goals are met
Maintain minimum standards for the department for quality and quantity of calls received
Foster interpersonal relationships, showing empathy and understanding towards staff, protecting individual self‑esteem. Understand own impact on others; interact effectively with peers, subordinates, and supervisors
Any other assigned duties as delegated by the Customer Service Supervisor
Required Qualifications
High School Diploma / GED or equivalent work experience
Must be 18 years of age OR older
1+ years of experience in Medicare and HMO environment
1+ years of claims processing or claims customer service experience
1+ years of authorization / referral processing experience
1+ years of customer service experience
Experience with spreadsheet applications such as Excel and/or Access
Experience with and knowledge of standard billing practices
Experience interpreting provider and health plan contracts
Experience using Windows programs including Microsoft Word, Outlook and Excel
Full‑time availability (Monday – Friday, 7:30 am – 4:00 pm PST; flexibility for 8‑hour shifts; occasional overtime)
Telecommuting Requirements
Reside within California
Ability to keep all company‑sensitive documents secure
Required to have a dedicated work area 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
Benefits Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far‑reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 – $31.63 per hour based on full‑time employment. We comply with all minimum wage laws as applicable.
Legal Statements At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.
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Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need. Here you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during normal business hours 7:30 am – 4:00 pm PST. It may be necessary, given the business need, to work occasional overtime.
We offer 2 weeks of paid training. The hours of training will be based on your schedule or will be discussed on your first day of employment.
Primary Responsibilities
Occasional shadowing / training of newly hired staff
Receives and records customer concerns via phone. Acts to resolve concerns in accordance for corporate guidelines and standards for all areas of claims, authorizations and IPA functionality
Functions as liaison between physician, health plan, and IPA staff
Ability to interpret provider and health plan contracts to ensure accurate responses to calls
Log issues into the Customer Service Tracking database that require resolution and/or follow‑up
Plan and organize workload to ensure efficient and timely resolution of issues
Respond to callers with the resolution of issues in a timely manner in accordance with the guidelines set by the department
Participates in telephonic surveys as required by management
Follow and support the guidelines set by the department and organization to ensure overall goals are met
Maintain minimum standards for the department for quality and quantity of calls received
Foster interpersonal relationships, showing empathy and understanding towards staff, protecting individual self‑esteem. Understand own impact on others; interact effectively with peers, subordinates, and supervisors
Any other assigned duties as delegated by the Customer Service Supervisor
Required Qualifications
High School Diploma / GED or equivalent work experience
Must be 18 years of age OR older
1+ years of experience in Medicare and HMO environment
1+ years of claims processing or claims customer service experience
1+ years of authorization / referral processing experience
1+ years of customer service experience
Experience with spreadsheet applications such as Excel and/or Access
Experience with and knowledge of standard billing practices
Experience interpreting provider and health plan contracts
Experience using Windows programs including Microsoft Word, Outlook and Excel
Full‑time availability (Monday – Friday, 7:30 am – 4:00 pm PST; flexibility for 8‑hour shifts; occasional overtime)
Telecommuting Requirements
Reside within California
Ability to keep all company‑sensitive documents secure
Required to have a dedicated work area 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
Benefits Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far‑reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 – $31.63 per hour based on full‑time employment. We comply with all minimum wage laws as applicable.
Legal Statements At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.
#J-18808-Ljbffr