Customer Service Representative

4 weeks ago

Nellis Air Force Base, Nevada, United States Optum Full time
Optum Job Description

At Optum, we're dedicated to delivering care and improving health outcomes for millions of people worldwide. As a Customer Service Representative, you'll play a vital role in connecting patients with the care, pharmacy benefits, data, and resources they need to live healthier lives.

Our team is guided by a culture of diversity, inclusion, and compassion. We're committed to advancing health equity and making a meaningful impact on the communities we serve.

As a Customer Service Representative, you'll work in a fast-paced call center environment, receiving and processing inbound calls from patients, providers, and medical staff. You'll execute outbound calls and electronic tasks to provide medical-related services, assist with appointment scheduling, prescriptions refills, facility locations, and lab results.

Key Responsibilities:

  • Answer a minimum of 11 calls per hour, resolving moderate to complex issues.
  • Schedule and verify appointments in clinical information systems.
  • Verify and update patient demographic and insurance information.
  • Send and receive tasks to provider offices to assist patients with access to medical care.
  • Receive and process expedited, stat, and at-risk referrals.
  • Contact patients to advise of appointment and referral status.
  • Extreme high-volume data entry.
  • Process and resolve expedited patient complaints.
  • Review and process medication refills.
  • Proactive response to inquiries from patients, providers, and internal medical personnel.

Requirements:

  • High School Diploma / GED or equivalent experience.
  • United States Citizenship.
  • Ability to obtain favorable adjudication following submission of Defense Health Agency eQuip Form SF86.
  • Must be 18 years of age or older.
  • Expanded knowledge and use of Excel.
  • Ability to demonstrate customer service and proper telephone etiquette.
  • Strong oral and written communication skills.
  • Advance computer skills in Windows environment.
  • Strong listening, critical thinking, decision-making, telephone, customer service, and problem-solving skills.
  • Ability to prioritize call types.
  • Ability to work full-time, Sunday-Saturday.

Preferred Qualifications:

  • 6+ months experience in a customer service/call center or healthcare environment.
  • Training in a medical office or customer service-related field.
  • CPT and ICD-10 coding.
  • Medical Terminology.
  • Advanced knowledge of insurance products.

Physical and Work Environment:

Normal Call Center environment, heavy phone and computer usage.

As a requirement of UnitedHealth Group's contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense eQuip Form SF86.

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