Senior Customer Service Representative

About the Company

Optum Insight is a prominent organization focused on revolutionizing the healthcare sector through advanced data and information technologies. Our goal is to streamline the exchange of health data, creating a seamless and efficient healthcare ecosystem. We work diligently to remove obstacles among care providers, payers, and consumers to elevate care quality while reducing expenses. Leveraging extensive industry experience and innovative technology, we enable healthcare entities to enhance risk management, improve quality indicators, and boost revenue. Our dedication to positively impacting lives worldwide remains fundamental to our operations, establishing us as a reliable partner in healthcare transformation.

Role Overview

The position of Senior Customer Service Representative is essential in providing empathetic and outstanding support to our consumers. This full-time remote role involves handling incoming calls from providers and members, responding to inquiries about claims, review statuses, and appeals. The job demands self-reliance, strong problem-solving capabilities, and strict compliance with company policies and legal standards. Candidates will manage various systems to investigate issues, assess case progress, and decide appropriate follow-up actions within the claim cycle. The role thrives in a dynamic setting where cooperation, compassionate communication, and adaptability are vital. Comprehensive training and ongoing assistance are provided to ensure success, thereby advancing our mission to improve healthcare outcomes through superior service.

Qualifications

• Possession of a High School Diploma or GED
• Minimum age of 18 years
• At least two years of professional experience in healthcare, insurance, or claims sectors
• Two or more years of experience providing telephonic customer service with high call volumes
• Proficient in Microsoft Office applications including Word, Outlook, and Excel
• Ability to work an eight-hour shift scheduled between Monday and Friday, from 7:00 AM to 7:00 PM CST, with shift details provided post-training
• Excellent communication and analytical problem-solving skills

Key Responsibilities

• Field inbound calls from providers and members through the Provider Inquiry Line, addressing inquiries about claims, reviews, and appeal statuses
• Investigate case progress using claims platforms and medical record databases to determine next appropriate actions
• Utilize multiple software applications simultaneously to resolve questions effectively
• Accurately record all customer interactions within designated systems
• Maintain a productivity rate of at least 95%
• Adhere strictly to federal, state, and corporate policies, including reimbursement and contract procedures
• Operate independently while contributing positively to the team dynamics
• Serve as a knowledge resource for fellow team members and promote collaborative learning
• Exhibit empathy, patience, and attentive listening when assisting internal and external clients
• Adapt efficiently to modifications in scheduling, procedures, and technology in a call center atmosphere
• Perform additional tasks as needed to meet team and organizational goals

Benefits Package

• Access to comprehensive plans covering health, dental, and vision insurance
• Structured paid training programs to enhance skills
• Recognition and incentive initiatives rewarding outstanding performance
• Potential for professional growth and career progression within the company
• Participation in a 401(k) retirement plan featuring company contributions
• Opportunities to buy company stock through equity purchase programs
• Supportive and flexible remote working environment with necessary tools
• Paid holidays and time off to support work-life balance

Equal Employment Opportunity

UnitedHealth Group is committed to fostering a diverse and inclusive workforce. We do not discriminate based on race, nationality, religion, age, gender, sexual orientation, gender identity, disability status, veteran status, or other protected classifications. All merit-qualified applicants will be considered irrespective of protected characteristics. Our workplace enforces a drug-free environment and requires candidates to pass a drug screening prior to employment.