Senior Customer Service Representative - Ontario, CA

UnitedHealth Group | Ontario, CA


If you are located within commutable distance of 3990 Concourse Suite 500, Ontario, CA 91764, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Energize your career with one of Healthcare's fastest growing companies.

You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that can definitely come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

The Senior Customer Service Representative is responsible for representing the organization and functioning as a key communicator for the organization's members and providers, educates and informs customers of organizations programs and services, promotes company's commitment to superior customer service, proactively and reactively seeks appropriate solutions to potential and existing service issues, identifies root cause issues and works diligently and cooperatively to minimize or eliminate issues.

This position is full-time (40 hours/week). Employees are required to work during our normal business hours of 8:00am - 5:00pm. 7:00am / 8:00am - 6 weeks in office to training on phone system, virtual training, shadowing other reps.

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

Primary Responsibilities:
  • Handling of escalated issues from CSRs
  • Monitoring call ques, breaks and lunches as back up to Lead and Supervisor
  • Manage Member Outreach and Satisfaction Surveys
  • Development & presentation of training materials
  • 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 member, 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 senior outreach program via telephone with approved script
  • 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

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 higher)
  • 3+ years of previous customer service experience
  • Ability to work any 8-hour shift schedule within our normal business hours of 8:00am - 5:00pm
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:
  • 3+ years of experience in Medicare and HMO environment
  • 3+ years of claims processing or claims customer service experience
  • 1+ years of authorization / referral processing experience
  • Bilingual

Telecommuting Requirements:
  • Reside within commutable distance of 3990 Concourse Suite 500, Ontario, CA 91764
  • 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)
  • Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do 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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November 29, 2022