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Senior Customer Service Representative - Work from Home

UnitedHealth Group | West Hills, CA | 08/28/2021

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Healthcare isn't just changing. It's growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that's what fueled these exciting new opportunities.

Who are we? Optum360. We're a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.

If you're looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work. SM

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 (40 hours/week) Monday - Friday. Employees are required MUST be able to work 8:30am to 5:00pm PST. It may be necessary, given the business need, to work occasional overtime. Our office is located at 8403 and 8401 Fallbrook, however, this position will begin as remote due to COVID-19 restrictions.

If you are located in the West Hills, CA area, you will have the flexibility to telecommute* as you take on some tough challenges. Training will be conducted onsite and virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Primary Responsibilities:
  • Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers
  • 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:
  • An education level of at least a High School Diploma or GED (or higher)
  • 1+ years of customer service experience or experience in a medical office, healthcare, call-center, or office setting analyzing and solving customer problems.
  • Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
  • All new hires will be required to successful complete the Customer Service training classes and demonstrate proficiency of the material
  • Must be able to work 8:30am to 5:00pm PST
  • Must reside within a 20-mile radius of West Hills, CA
  • 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
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:
  • Prior healthcare experience
  • Knowledge of billing / finance and eligibility processes, practices, and concepts

Soft Skills:
  • Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product
  • Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
  • Proficient in translating health care-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
  • Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner
  • Proficient conflict management skills including the ability to resolve stressful situations

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

Careers with Optum360. At Optum360, we're on the forefront of health care innovation. With health care costs and compliance pressures increasing every day, our employees are committed to making the financial side more efficient, transferable and sustainable for everyone. We're part of the Optum and UnitedHealth Group family of companies, making us part of a global effort to improve lives through better health care. In other words, it's a great time to be part of the Optum360 team. Take a closer look now and discover why a career here could be the start to doing your life's best work. SM

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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September 27, 2021