Senior Customer Service Representative

This position is Remote in EST. 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.

Under direct supervision, plays an expanded and advanced level role in the creation of superior access for patients. Duties include but are not limited to handling incoming patient inquires and assisting patients in the management of appointments/care. Through a variety of support duties that facilitate the work of an interdisciplinary coordinated care delivery model, the Patient Service Representative II plays an integral role in the support of our patients. As a level II representative, utilizes advanced skill set to perform all duties of the Patient Service Representative I and serves as resource and mentor for lower level representatives. Handles the more complex issues arising through incoming calls. Provides extraordinary customer service and strong problem solving skills to strengthen the patient/clinician relationship. Must have clear verbal and written communication skills to ensure improve patient access.

This position is part time (30 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 10-hour shift schedules during our normal business hours of 9:30 pm -8:00 am. It may be necessary, given the business need, to work occasional overtime.

We offer 6 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities:

• Maintains a higher degree of technical expertise than Patient Services Representative I and serves as role model to Patient Services Representative I's. Able to problem-solve and serve as a resource to other Patient Services Representatives.
• Screens all incoming patient inquires (through phone, online/medical record message, or other means) to determine whether those inquiries can be appropriately handled by the Patient Service Representative or if they need to be directed to other team members.
• Courteous, friendly, problem solver with customer service, patient focused communication.
  Acts as a role model for other support staff and demonstrates a high level of competency in Patient Service Representative responsibilities.
• Proactively identifies issues and works to resolve them in areas involving patient satisfaction, patient flow, and compliance with procedures and guidelines. Advocates for patients as appropriate.
• Identifies and assists in resolving operational difficulties and communicates with supervisor regarding department issues and problems as necessary. Demonstrates a high level of competency when handling difficult phone calls and dealing with complex issues.
• Initiates request for forms, letters, medication renewals, referrals, prior authorizations, and any other administrative needs submitted by patients and answers any corresponding questions. Understands all documents and processes.
• Reviews and facilitates the updating of missing /outdated information in the patient record, such as demographics, primary care physician selection, and insurance.
• Develop and maintain effective and efficient communication with the patient, interdisciplinary team, department staff, providers, and other agencies.
• Reviews department appointment schedules to ensure that clinic utilization is optimized and effectively supports the needs of the clinics as well as the needs of the patients.
• Assists with data collection activities and provide appropriate follow up for statistical reports or required studies, ensuring data is properly collected and accurate (e.g. no show reports, telephone statistics).
• Receives escalated issues and determines appropriate action and/or works with clinical team for decision.
• Effectively deescalates issues with upset patients and practices. Uses advanced listening techniques to understand the issue and give patients options as they are available. Escalates to supervisors only as needed.
• Supports, mentors and trains lower level assistants.
• Participates in problem solving activities, focusing on productivity and quality. Works with supervisors to ensure continuous improvement of the department.
• Participates in special projects and ongoing programs unique to the department.
• May represent department on groups and teams related to upgrades of the electronic medical record.
• Performs functions of a Patient Service Representative I.

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:

• HS Diploma/GED OR equivalent work experience
• Must be 18 years of age OR older
• 3+ years of experience in a clinical or customer service setting
• Proficient in Microsoft Office programs
• Flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:30 pm -8:00 am.

Preferred Qualifications:

• Experience with EPIC
• Experience working overnight
• Working knowledge of patient related documents preferred.
• Call center experience
• Reside within New England Massachusetts

Telecommuting Requirements:

• Reside within the EST Time Zone.
• 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.

Soft Skills:

• Able to communicate in a professional and appropriate manner.
• Strong interpersonal skills
• Strong time management skills
• Ample organizational skills

*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 $17.98 - $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

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