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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 compassionately deliver an exceptional experience to between 50 to 70 callers per day, always remembering that there is a real person on the other end of the phone who is looking for help, guidance, and support. You'll also provide support to your team members by serving as a resource or subject matter expert. Both of these are opportunities for you to identify and exceed our customer expectations by committing to and building strong relationships internally and externally. At the end, you’ll know you performed with integrity and delivered the best customer service experience making all your customers and team members feel better because they talked to you.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm EST. It may be necessary, given the business need, to work occasional overtime.

We offer 6 weeks of on-the-job training. The hours of training will be aligned with your schedule.

If you are located in CST or EST Time Zones, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Handle escalated calls, resolving more complex customer issues in a one and done manner

• 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

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

• Must be 18 years or older

• 1+ years of healthcare customer service experience

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

• Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm EST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• 1+ years Customer Service Representative (CSR) experience OR 1+ years of experience in an office setting, call center setting or phone support role

• Medical terminology experience

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

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

Telecommuting Requirements:

• Reside in Central Standard Time or Eastern Standard Time zones.

• 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.

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

Connecticut, New Jersey, New York, Rhode Island, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.54 to $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.

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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