Customer Service Representative

3 weeks ago


Blue Diamond, 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 thrive.

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 key member of our call center team, you'll work under supervision to receive and process 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. You'll also resolve routine to complex issues, ensuring seamless communication and exceptional customer service.

Key Responsibilities:

  • Answer a minimum of 11 calls per hour, resolving moderate to complex issues.
  • Schedule and verify appointments in our clinical information system.
  • 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, (the National Agency Check Legal and Credit or NACLC).

Successful completion of the NACLC process is a requirement for continued employment in this role. NACLC processing will be initiated by our TRICARE Security Officer post-offer and can take 3-6 months for a final decision communication from the Department of Defense.

Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received.

Failure to obtain final NACLC approval will result in termination from this role.

Nevada Residents Only:

The hourly range for this role is $28.27 per hour. Pay is based on several factors, including 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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