If you are located within 30 miles of Irving, TX, you will have the flexibility to telecommute * (work from home) as you take on some tough challenges.

　　Cuando se trata de salir adelante y tienes la voluntad de ganar, vamos a llamarlo gran potencial de carrera ! Imagine being able to get answers to your health plan questions from someone who speaks the same language as you do. Or, the opposite, not being able to get the answers. At UnitedHealth Group , we want our customers to get those answers by speaking to one of our Bilingual Representatives. If you're fluent in English and Spanish, we can show you how to put all of your skills, your passions and your energy to work in a fast - growing environment.

　　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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

　　As a Senior Customer Service Representative , 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 of these 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.

　　This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 10:00am – 6:00pm EST/9:00am - 5:00pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.

　　We offer 6 weeks of paid training. The hours during training will be 9:00am – 5:00pmEST/8:00am – 4pmCST.

　　*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

　　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 Quest Diagnostics 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 or older

　　1+ years experience with processing Health Care Claims

　　1+ years of experience working in a medical office, health care, call center or office setting analyzing and solving customer problems

　　1+ experience working in a fast-paced environment, with the ability to easily adjust to new priorities and new processes and performing multiple concurrent tasks with strong attention to detail.

　　Familiarity with Medical Terminology

　　Ability to successfully complete the Customer Service training classes and demonstrate proficiency of the material

　　Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications

　　Bilingual fluency in English and Spanish – Must be able to translate complex medical terminology and insurance claim information specific to individual inquiries

　　Ability to work our normal business hours of 10:00am - 6:00pm EST/ 9:00am-5:00pm CST. It may be necessary, given the business need, to work occasional overtime.

　　Telecommuting Requirements:

　　Reside within 30 miles of Irving, TX

　　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

　　At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for 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.

　　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 .

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