Customer Service Representative - Irvine, CA

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 answering a minimum of 60 incoming calls and placement of outbound calls from/to members, health plan providers and provider offices.  

Primary Responsibilities:

• Answer a minimum of 60 incoming calls and e-mails in a courteous and professional manner


• Provide status of authorizations, claims and verify eligibility for all inquiries coming into the call center


• Answer questions regarding both provider and member service issues such as PCP information, senior programs, new member inquiries, updated physician lists, routine technology inquiries, claims and provider membership


• Schedule interpreter services as needed


• Resolve member and provider problems generated from call center


• All written and electronic correspondence must be answered within 48 hours


• Return voice mail calls within 24 hours of assignment


• Maintain up-to-date tools and resources and utilize these in a manner that allows calls to stay within Customer Service department while providing optimal service levels to the customer


• Regular and consistent attendance

Required Qualifications:

• High school diploma or GED; plus 1+ years of medical front office experience; or equivalent combination of education and experience


• 1+ years of experience in medical claims


• Knowledge of CTP, ICD-9 codes


• Ability to read and comprehend simple instruction, short correspondence, and memos.


• Ability to write simple correspondence


• Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization


• Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's


• Ability to apply commonsense understanding to carry out instructions furnished in written, oral, or diagram form


• Proficient in Microsoft Outlook, Word, and Excel


• Make sound judgments based on situation


• Manage time efficiently with low to medium management


• Type a minimum of 35 words a minute


• Navigate the internet


• Operate general office equipment, i.e., copier and fax

What's the first thing that happens when one of the most successful physician groups in Orange County comes together with a global leader in health care? Opportunity. With Monarch HealthCare joining Optum and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. With a vibrant network of hospitals and urgent care centers, we're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting 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, Irvine, CA