Call Center 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 Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. It’s a big step forward when you realize that you’ve earned the trust to lead a team. Now, let’s determine just how big that step can be. Take on this role with UnitedHealth Group and you’ll be part of a team that’s reshaping how health care works for millions. Now, you can take advantage of some of the best resources and tools in the world to help serve our members. You’ll play a lead role in a high volume, focused and performance driven call center where the goal is always to connect with members and enhance the customer experience. This is no small opportunity. This is where you can bring your compassion for others while building your career. This position is full-time, Monday - Friday. Employees are required to have flexibility to work during our normal business hours of 8:00 am - 5:00 pm EST. This will be on the job training and the hours during training will be during normal business hours. Primary Responsibilities: Provide expertise and customer service support to long-term care providers and members Serve as the liaison to a complex customer base to manage first level response and resolution of escalated issues with external and internal customers Identify and resolve operational problems using defined processes, expertise and judgment Investigate claim, prior authorization, enrollment and revalidation and/or customer service issues as identified and communicate resolution to customers Provide feedback to team members regarding improvement opportunities This role is equally challenging and rewarding. Within a high-volume environment, you’ll need to model and act as an ambassador for the company while solving complex health care inquires The Call Center Representative acts as a customer advocate to resolve escalated and complex issues. 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 healthcare customer service experience analyzing and solving customer problems 1+ years of medical claims (reviewing/processing) experience. 1+ years of working in a call center environment or experience managing heavy call volumes Knowledge reviewing medical codes (CPT, HCPCS, and/or ICD-10) Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications Ability to work Monday - Friday, 8:00 am - 5:00 pm EST Preferred Qualifications: Experience with Medical Prior Authorizations 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 including ability to understand multiple products and multiple levels of benefits within each product *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 $20 - $36 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. 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.