Remote Senior Customer Service Representative Jobs

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization 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 of these 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 (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8‑hour shift schedules during our normal business hours of 7:30 am – 4:00 pm PST). It may be necessary, given the business need, to work occasional overtime. We offer 2 weeks of on‑the‑job training. The hours of the training will be aligned with your schedule.

• 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

• High School Diploma / GED OR equivalent work experience
• Must be 18 years old OR older
• 1+ years of customer service experience OR experience in a medical office, health care, call‑center or office setting analyzing and solving customer problems
• Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Experience translating health care‑related jargon and complex processes into simple, step‑by‑step instructions customers can understand and act upon
• Ability to work fulltime, Monday - Friday. Employees are required to have flexibility to work any of our 8‑hour shift schedules during our normal business hours of 7:30 am – 4:00 pm. It may be necessary, given the business need, to work occasional overtime

• Health care experience
• Bilingual fluency in English and Spanish
• Knowledge of billing/finance and eligibility processes, practices and concepts
• Reside within the state of California

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high‑speed internet connection or leverage an existing high‑speed internet service

• Proficient conflict management skills including the ability to resolve stressful situations
• Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far‑reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 – $31.63 per hour based on full‑time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.