Healthcare isn’t just changing. It’s growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that’s what fueled these exciting new opportunities.
Who are we? Optum360. We’re a dynamic new partnership formed by Quest and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we’ll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.
If you’re looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It’s an opportunity to do your life’s best work.sm
Positions in this function are responsible for providing expertise and customer service support to members, customers, and / or providers. Direct phone - based customer interaction to answer and resolve a wide variety of inquiries. Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.
- Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
- Help guide and educate customers about the fundamentals and benefits of consumer - driven health care topics to include managing their health and well-being by selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider
- 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 myuhc.com and other 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
- Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance
- Good organizational skills
- Ability to work independently and as part of a team
- Ability to work overtime as needed, based on department needs
- Moderate work experience within own function
- Some work is completed without established procedures
- Basic tasks are completed without review by others
- Supervision / guidance is required for higher level tasks
- High School Diploma / GED (or higher)
- 1+ years of experience in customer service role using the telephone and computer as the primary instruments to perform job duties
- All new hires will be required to successfully complete the UnitedHealthcare Operations Customer Service Advocate training classes and demonstrate proficiency of the material
- Ability to work regularly scheduled shifts within our hours of operation (8:30 AM to 6:30 PM Monday - Thursday, 8:30 AM to 5:30 PM on Fridays), where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over - time and / or weekends, as needed
- Associate's Degree (or higher)
- Experience in a healthcare or insurance setting
- Experience with translating healthcare - related jargon and complex processes into simple, step - by - step instructions customers can understand and act upon
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Keywords: Customer Service Representative, CSR, Optum, Quest, 360, Marlboro, Worcester, Marlborough