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Senior Complex Customer Care Representative

Senior Complex Customer Care Representative

Phoenix StaffingPhoenix, AZ, US
15 hours ago
Job type
  • Full-time
Job description

Senior Complex Customer Care Representative

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 Complex Customer Care Representative, as part of the Resolution Experience Team, 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 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. Ability to work full-time, Monday - Friday. Employees are required to be flexible to work an 8-hour shift during the hours of 5 : 00am - 8 : 00pm CST. Mandatory overtime is required during peak season (January- February) and based on business need and weekends. This will be on the job training and the hours during training will be 5 : 00am to 8 : 00pm CST, Monday - Friday.

Primary Responsibilities :

  • 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

    • 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 :

  • High School Diploma / GED
  • Must be 18 years of age OR older
  • 2+ years of customer service experience analyzing and solving customer problems OR 2+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
  • 9+ months of previous call center experience
  • First Call Resolution experience
  • Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
  • Ability to work full-time, Monday - Friday. Employees are required to be flexible to work an 8-hour shift during the hours of 5 : 00am - 8 : 00pm CST. Mandatory overtime is required during peak season (January- February) and based on business need and weekends.

    • Preferred Qualifications :

  • 1+ years of Customer Service Representative (CSR) experience OR 1+ years of experience in an office setting, call center setting or phone support role
  • Local to Draper, UT or Cypress, CA

    • Telecommuting Requirements :

  • 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 :

  • Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product
  • Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and / or weekends, as needed

    • 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). The hourly pay for this role will range from $20.00 - $35.72 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. 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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