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Senior Customer Service Representative - Remote in South Orange County, CA

Company: UnitedHealth Group
Location: Irvine
Posted on: March 19, 2023

Job Description:

If you are located within Reside within 45 miles of corporate office location in Irvine, CA, you will have the flexibility to telecommute (work from home) as you take on some tough challenges.

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 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 8:30am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located at 11 Technology Dr., Irvine, CA 92618.

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:
    • High school diploma / GED (or higher) OR 10+ years of equivalent working experience
    • 1+ years of prior health care experience
    • 1+ years of customer service experience OR experience in a medical office, health care, 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
      Preferred Qualifications:
      • Knowledge of billing/finance and eligibility processes, practices, and concepts
      • Bilingual in English and any of the following languages: Spanish, Vietnamese, Mandarin, Korean or Farsi
      • 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 within 45 miles of corporate office location at 11 Technology Dr., Irvine, CA 92618
        • 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
          Soft Skills:
          • Ability to remain organized, focused, and productive on highly detailed repetitive tasks
          • Ability to de-escalate calls, listen to customer needs and respond appropriately with compassion and empathy
          • Excellent problem-solving skills, including the ability to independently research issues using multiple information sources
          • Ability to multi-task for extended periods of time, including managing calls while also navigating multiple computer systems
            Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged, and high-performing teams to help solve important challenges.

            California Residents Only: The salary range for California residents is $16.00 - $31.44. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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 .



Keywords: UnitedHealth Group, Irvine , Senior Customer Service Representative - Remote in South Orange County, CA, Hospitality & Tourism , Irvine, California

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