Customer Service Representative Lead - Full-time / Part-time

Position Description:



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.

Primary Responsibilities:

• Responsible for providing expertise and customer
  service support to members, customers, and or providers. 
• Direct phone-based customer interaction to answer and resolve a wide variety of
  inquiries.
• Extensive work experience, possibly in multiple
  functions.
• Experience in all claims platforms- UNET, OHBS Facets,
  familiar with Cosmos
• Work does not usually require established procedures.
• Works independently.
• Mentors others.
• Acts as a resource for others.
• Applies knowledge/skills to complex activities.
• Demonstrates a depth and breadth of knowledge and
  skills in own area and is often able to apply these outside of own
  function.
• Often acts as a technical resource to others in own
  function.
• Anticipates customer needs and proactively identifies
  solutions.
• Solves complex problems on own; proactively identifies
  new solutions to problems.
• Plans, prioritize, organize and complete work to meet
  established objectives.
• Acts as a facilitator to resolve conflicts on team;
  seen as key team member on project teams spanning more than own function
• Functional Competency &
  Description
• Ask appropriate questions and listen actively to
  identify underlying questions and issues (e.g., root cause analysis)
• Gather appropriate data and information and perform
  initial investigation to determine scope and depth of question/issue
• Identify and coordinate internal resources across
  multiple departments to address client situations, and escalate to
  appropriate resources as needed
• Identify and communicate steps and solutions to caller
  questions and issues, using appropriate problem-solving skills and
  established guidelines, where available (e.g., workarounds, descriptions
  of relevant processes)
• Offer additional options to provide solutions and
  positive outcomes for callers (e.g., online access to relevant
  information, additional plan benefits, workarounds for prescription
  delays)
• Make outbound calls to resolve caller questions and
  issues (e.g., to callers, providers, members)
• Drive resolution of caller questions and issues on the
  first call whenever possible (e.g., first-call resolution, one-and-done)
• Ensure proper documentation of caller questions and
  issues (e.g., research conducted, steps required, final resolution)
• Manage caller conversations appropriately (e.g.,
  provide a good first impression, command attention and respect, maintain
• professional tone, demonstrate confidence, de-escalate
  and defuse callers as needed)
• Maintain ongoing communications with callers during the
  resolution process to communicate status updates and other required
  information
• Maintain focus on caller interactions without being
  distracted by other factors (e.g., system usage, pop-up alerts, VCC data)

 Requirements:

• High School Diploma, GED or 10 years of work experience
• 3+ years previous experience in a leadership role (ie:
  Coach, SME, Supervisor, etc)
• 1+ year of Claims experience 
• 1+ year of knowledge of medical claims billing ICD9,
  CPT, or HCPC codes
• Authorization to work in the United States
• Must be able to work Mon-Fri, 7:00 am - 7:00 pm
• Must be currently working in Optum Behavior Health
  segment

Work Environment: 

• Extended periods of sitting at a computer and use of
  hands/fingers across keyboard or mouse
• Office environment

Careers with Optum. Here's the idea. We built three focused businesses
organized around one giant objective; make health care 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 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. It's a culture of optimism that's not like
any place you've ever worked. OptumRx, OptumInsight, OptumHealth. Three
incredible ideas in one incredible company and a singular opportunity to do
your life's best work.

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.