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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 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 Senior Customer Service Representative , you'll provide our members with the information they need to make better decisions about their health, helping them get access to the right care the first time. Every day, you'll provide compassionate and empathetic support to 50 to 70 callers providing guidance, support, and resolution for escalated issues. This is no small opportunity. This is where you can bring your compassion for others while building your career.

This position is full time (40 hours/week) Sunday - Saturday from 4:25am - 9:00 pm MST. Training will be conducted virtually from your home.

We offer 5 weeks of paid training. The hours during training will be 8am to 4:30pm MST, 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:

• Answer incoming phone calls from customers 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)

• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems

• Intervene with care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed

• Assist customers in navigating UnitedHealth Group websites and encourage and reassure them to become self-sufficient

• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member

• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues

• Provide education and status on previously submitted pre-authorizations or pre-determination requests

• Meet the performance goals established for the position in the areas of: efficiency, call quality, provider satisfaction, first call resolution and attendance

This role is equally challenging and rewarding. You'll be on the phone for long periods of time and encounter all types of communication styles and personalities as you help resolve conflicts or issues. You'll deal with stressful situations and resolve complex health care concerns in a positive, simplified manner so that callers fully understand their health care plans and solutions.

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 years of work experience

• Must be 18 years of age OR older

• 1+ years of customer service experience OR experience in a medical office, health care, call-center or office setting analyzing and solving customer problems

• Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications

• Proficient in translating health care-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon

Preferred Qualifications:

• Prior health care experience

• Knowledge of billing/finance and eligibility processes, practices and concepts

Soft Skills:

• Proficient conflict management skills including the ability to resolve stressful situations

• Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy

• Ability to keep all company sensitive documents secure (if applicable)

• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only: The hourly range for this is $16.54 - $32.55 per hour. 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.

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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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