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in Carlsbad, CA

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Hours Full-time, Part-time
Location Carlsbad, CA
Carlsbad, California

About this job

 Don't wait to apply - we have training classes starting soon that are designed to set you up for success!


 


You want more challenge. You want more opportunity. You want more reasons to head in to work every day.  We want more people like you. UnitedHealth Group Customer Care Centers are home to a team that lives and breathes restless. We're still finding ways to outdo what we did yesterday. And that's what makes us one of the fastest growing businesses in the country and the world. Now it's time to discover how our continuous expansion can drive incredible growth in your career.

The Customer Service Representative is responsible for answering incoming calls from customers while ensuring a high level of customer service and maximizing productivity. The responsibilities of this position are providing customer service support to members, customers, and/or providers. Direct phone-based customer interaction to answer and resolve a wide variety of inquiries. Individuals chosen for this position will answer questions related to pharmacy benefits, mail order and pharmacy assistance calls.
 
Responsibilities:     




  • Answers incoming calls; assists customers/pharmacies/physicians with orders and reorders, benefit eligibility questions and prescription status inquiries. Escalates drug related calls to appropriate pharmacist.

  • Assist pharmacies and members on all issues related to processing of pharmacy claims.  Determines appropriateness of overriding pharmacy claims edits and error messages.

  • Coordinates internal resolution of claims exceptions and other issues.

  • Makes outbound calls on prescriptions with hold orders and payment issues.

  • May also assist with entering new prescription orders into system.

  • Educates customers on benefits, use of plan, formulary, premiums and status of orders, claims or inquiries.

  • Other duties as assigned.


To learn even more about this position, hear from our Customer Service Representatives. to watch a short video about the job.

Requirements

Qualifications:



  • 1 year of customer service experience analyzing and solving customer problems, OR 1 year of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties

  • An education level of at least a high school diploma or GED OR 10 years of equivalent working experience

  • Authorization to work in the United States

  • Available to work 40 hours per week anytime within the operating hours of the site

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

  • Ability to navigate a computer while on the phone

  • Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product

  • Ability to remain focused and productive each day though tasks may be repetitive
Physical Requirements and Work Environment:


  • Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer

  • Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity

 


 


There are several steps in our hiring process – it's a thorough process because we want to ensure the best job and culture fit for you and for us. In today's ultra-competitive job market, the importance of putting your best foot forward is more important than ever. And you can start by completing all required sections of your application. (i.e. profile, history, certifications and application/job questions). Once you submit your resume, you'll receive an email with next steps. This may include a link for an on-line pre-screening test that we ask you to complete as part of our selection process. You may also be asked to complete a digital video interview, but we will offer full instructions and tips to help you. After you have completed all of these steps, you can check on the status of your application at any time, but you will also be notified via e-mail.


 


 


OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.


 


If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable health care solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.  Join us and start doing 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, 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.


 


Keywords: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, health care, office, phone support, training class