Customer Service Representative - Las Vegas, NV - Full-time / Part-time

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.(sm)

UnitedHealth Group is working to create the health care system of tomorrow. Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good. Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant, and built for speed.

The Customer Service Representative is responsible for responding to referrals request generated via computer, fax or telephone. Answers all incoming calls via Automatic Call Distribution and making outbound calls to obtain demographic, referral information, verify insurance eligibility and benefits and obtain authorizations as needed.

Primary Responsibilities:

• Handles incoming and outbound calls facilitating a positive customer experience


• Log all Fee For Service and Cap referrals


• Verify insurance eligibility and benefits either on-line or via the telephone before admitting a customer on service


• Data entry for all customer demographics correctly into operating system


• Obtains prior authorization and secures co-pay as defined by policy


• Routes referral and client information to the appropriate venue and notifies referral source of disposition when unable to accept referral

Required Qualifications:

• 
  
  High school diploma or equivalent


• 2+ years of experience in customer service


• 3+ years of experience in a call center environment


• 
  
  Strong understanding of Medicare, Medicaid, HMO and Commercial insurances verification processes


• 
  
  Knowledge of medical terminology, ICD coding and CPT coding


• 
  
  Demonstrated skills in Windows computer systems


• 
  
  Strong organizational and time management abilities


• 
  
  Ability to prioritize work load

Preferred Qualifications:

• Customer service experience in Home Medical Equipment (HME) or Pharmacy Intake

Southwest Medical Associates (SMA) is a multi-specialty group of physicians, Nurse Practitioners and Physician Assistants, consisting of over 200 providers, fourteen clinical locations including nine health care centers, five urgent care clinics and an outpatient surgery center. SMA offers patients compassion, innovation, and quality care throughout southern Nevada. SMA is headquartered in the greater Las Vegas, NV area.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Job Keywords: Customer Service Rep, Call Center Rep, Las Vegas, NV