[Remote] Senior Customer Service Representative

Note: The job is a remote job and is open to candidates in USA. Optum is hiring a Senior Customer Service Representative to support providers and customers across healthcare programs and services. The role resolves service issues, coordinates between physicians, health plans, and IPA staff, and supports accurate responses concerning claims, authorizations, and contracts.

Responsibilities

• Responsible for representing the organization and functioning as a key communicator for the organizations providers
• Educates and informs customers of organizations programs and services
• Promotes company's commitment to superior customer service
• Proactively and reactively seeks appropriate solutions to potential and existing service issues
• Identifies root cause issues and works diligently and cooperatively to minimize or eliminate issues
• Occasional shadowing/training of newly hired staff
• Receives and records customer concerns via phone. Acts to resolve concerns in accordance for corporate guidelines and standards for all areas of claims, authorizations and IPA functionality
• Functions as liaison between physician, health plan, and IPA staff
• Ability to interpret provider and health plan contracts to ensure accurate responses to calls
• Log issues into the Customer Service Tracking database that require resolution and/or follow-up
• Plan and organize workload to ensure efficient and timely resolution of issues
• Respond to callers with the resolution of issues in a timely manner in accordance with the guidelines set by the department
• Participates in telephonic surveys as required by management
• Follow and support the guidelines set by the department and organization to ensure overall goals are met
• Maintain minimum standards for the department for quality and quantity of calls received
• Foster interpersonal relationships, showing empathy and understanding towards staff, protecting individual self-esteem. Understand own impact on others; interact effectively with peers, subordinates, and supervisors
• Any other assigned duties as delegated by the Customer Service Supervisor

Skills

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Ability to type 40 - 50 words per minute
• Strong organizational skills
• Excellent communication and presentation skills
• Good grammar, voice and diction
• Ability to retain composure
• 2+ years of office experience working within scheduling or training in the medical field setting
• 1+ years of claims processing or claims customer service experience
• 1+ years of authorization/referral processing experience
• Knowledge of standard billing practices
• Ability to interpret provider and health plan contracts

Benefits

• The flexibility to telecommute from anywhere within the U.S.
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Company Overview

Company H1B Sponsorship