Customer Service Representative - Healthcare

Optum, a UnitedHealth Group Company; Cebu City; On-site; PHP 201,000 - 357,000; Full time

Benefits offered by this job

Market Competitive Pay Levels

Retirement Plan

Medical Plan (HMO) from Day 1

Dental, Medical, and Optical Reimburse

Life and Disability Insurance

Paid Time-Off Benefits

Sick Leave Conversion

Tuition Reimbursement

Employee Assistance Program (EAP)

Annual Performance Based Merit Increas

Employee Recognition

Training and Staff Development

Employee Referral Program

Employee Volunteerism Opportunity

All Mandatory Statutory Benefits

Job summary

Optum is seeking a Patient Navigator/Clinical Admin Coordinator to deliver a timely and compassionate experience for established patients seeking services through Optum Behavioral Care. The role involves gathering and verifying comprehensive patient data, triaging to appropriate providers, and coordinating scheduling and referrals to ensure seamless access to behavioral health services.

This position supports client operations across multiple US regions and requires steady, in-office presence.

Qualifications

• Good problem-solving skills.
• Demonstrates depth of knowledge and skills in call center, medical, insurance, or collections domain.
• Able to work on a shifting schedule.
• Able to report full time in the office.

Responsibilities

• Gather and verify demographic, insurance, financial, clinical, and psychosocial information to support patient screenings and care coordination, accurately documents patient information within designated tracking systems, and assesses caller urgency.
• Escalate high-priority concerns and direct patients to the most appropriate provider or service line through triage and routing.
• Support patients and providers across the Northeast, Midwest, West and South regions in the US.
• Serve as a subject matter expert for OBC providers, programs, and service lines, handling inbound inquiries and referrals, coordinating appointment scheduling, rescheduling, cancellations, and medication refill requests.

Job description

About the role

The role of a Patient Navigator/Clinical Admin Coordinator is responsible for delivering a timely, compassionate, and positive experience for established patients seeking services through Optum Behavioral Care (OBC).

Key responsibilities

• The role gathers and verifies demographic, insurance, financial, clinical, and psychosocial information to support patient screenings and care coordination, accurately documents patient information within designated tracking systems, and assesses each caller's situation to identify and evaluate the level of support required based on urgency.
• Using established guidelines, the Patient Navigator appropriately escalates high-priority concerns and directs patients to the most appropriate provider or service line through effective triage and routing processes, ensuring seamless access to care and an exceptional patient experience.
• This role supports patients and providers across the Northeast, Midwest, West and South regions in the US.
• Serving as a subject matter expert for OBC providers, programs, and service lines, the Patient Navigator manages inbound inquiries and referrals received through live phone calls, scheduled callbacks, web forms, and fax/electronic referrals, while coordinating appointment scheduling, rescheduling, cancellations, and medication refill requests for behavioral health services.

About you

• Accepts College Graduates of Medical Allied Course without BPO experience
• Accepts Non Medical Allied Graduates but must have at least 1 year Healthcare BPO experience

• Good problem-solving skills
• Demonstrates great depth of knowledge and skills in call center, medical, insurance, or collections domain expertise
• Able to work on a shifting schedule
• Able to report full time in the office

Work Arrangement

• Must be willing to work onsite.

WHAT WE OFFER:

• Market Competitive Pay Levels
• Retirement Plan
• Medical Plan (HMO) from Day 1 of employment
• Dental, Medical, and Optical Reimbursements
• Life and Disability Insurance
• Paid Time-Off Benefits
• Sick Leave Conversion
• Tuition Reimbursement
• Employee Assistance Program (EAP)
• Annual Performance Based Merit Increases
• Employee Recognition
• Training and Staff Development
• Employee Referral Program
• Employee Volunteerism Opportunity
• All Mandatory Statutory Benefits

WHO WE ARE:

Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.

UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.

We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.

As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.

Elevate your career with a leading health care company while improving lives.

Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together.