Customer Service Representative – National Remote

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.

This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime.

We offer 3 weeks of paid training. The hours during training will be an 8-hour shift between 9:00am to 5:30pm EST, Monday – Friday. Training will be conducted virtually from your home.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Initiating Prior authorizations requests
• Validating insurance types (Medicaid, Medicare, Commercial, etc.)
• Accessing multiple Optum resources to check Prior authorizations status and benefits
• Problem-solve with decisiveness and urgency and escalate to operations partners, team leads, management and other stakeholders
• Ensure patients and providers are supported by following escalation through to finish
• Enters notes/information into pharmacy processing system.
• Focus on patient care and quality assurance
• Maintain strict confidentiality and adhere to all privacy and security regulations when handling sensitive information

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 OR equivalent work experience
• Must be 18 years of age OR Older
• 1+ years of Customer Service experience
• Healthcare industry experience
• Microsoft Office proficiency (Word, Excel, Outlook, OneNote & Teams)
• Ability to self-manage and work independently
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Prior Authorization Experience
• Experience in pharmacy
• Previous experience working in a call center environment
• Previous experience working in a metrics-based environment
• Previous experience working in a virtual environment
• General knowledge of pharmacy laws, practices and procedures
• Knowledge of insurance and third-party billing systems

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 manage multiple tasks and set priorities
• Ability to establish and execute action plans; able to share your past successes
• Ability to be diplomatic when faced with conflict, and always communicate in a professional and courteous manner
• Ability to produce quality results with a detail-oriented focus
• General knowledge of pharmacy laws, practices and procedures
• Knowledge of insurance and third-party billing systems

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.00 to $28.27 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

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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