Senior Customer Service Representative

This position is Remote in Central, Mountain, or Pacific Time Zone. You will have the flexibility to work remotely* 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.

Join us to start Caring. Connecting. Growing together.

As a Senior Customer Service Representative, you'll compassionately deliver an exceptional experience to between 45 to 65 callers per day. Always remember that there is a real person on the other end of the phone who is looking for help, guidance, and support. You will also provide support to your team members by serving as a resource or subject matter expert. 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 or MST. It may be necessary, given the business need, to work occasional overtime.

We offer 3 weeks. The hours of the training will be 7:30 am - 4:00 pm PST. During the training period the expectation this will be a 40 hour per week schedule and then moving to a part-time position within the hours listed above.

Primary Responsibilities:

• Review and research incoming healthcare claim calls from providers (doctors, clinics, etc.) by navigating multiple computer systems and platforms and verifies the data / information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Communicate and collaborate with providers to resolve issues, using clear, simple language to ensure understanding
• Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, and attendance
• Answer incoming phone calls from members 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)