Escalation Specialist - Phoenix, AZ

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)
 
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
 
Primary Responsibilities:


Ability to work cooperatively in a team environment – employee will work with Member Service coworkers, Account Managers and other teams within Catamaran to meet our clients’ needs

Maintain a clear understanding of each clients’ policies, procedures and individual needs

Research and handle escalated issues identified by Account Management, clients or members

Collect accurate information and document unresolved issues.  Work with teammates, Account Managers and other resources to solve those issues

Assist pharmacies and/or clients in resolving a variety of daily processing obstacles - problem solving and the ability to communicate solutions is essential

Communicate effectively and clearly with members regarding questions about their pharmacy plan coverage, co-pays, deductibles, and other aspects of their pharmacy program

Make outbound calls to follow up with members requiring additional information obtained through research or coordination with other departments

Collect accurate information and document unresolved issues. Work with teammates, Account Managers and other resources to solve those issues

Fulfill any client requests that are received directly from clients and/or members

Maintain records of actions taken including documenting clients’ calls, overrides entered, modifications to records within the RxCLAIM system, and any other tasks completed within a member’s profile

File and maintain paper records in an organized manner

Perform daily functions as well as other projects and responsibilities assigned

Required Qualifications:


Customer Service and or Pharmacy Technician or basic understanding of pharmacy benefit designs

Third Party claims processing experience beneficial OR 1-2 years of experience in customer service

High school diploma or equivalent required

Ability to speak clearly and effectively communicate instructions over the phone

Positive attitude, willingness to learn and improve on a daily basis

Excellent organizational skills

Basic typing skills

Basic math and spelling skills, as well as problem-solving skills, ability to multi-task and juggle multiple and changing priorities

Flexible scheduling, including weeknights and weekends
 
Careers with OptumRx. We’re one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you’ll fill far more than prescriptions. As a member of one of our pharmacy teams, you’re empowered to be your best and do whatever it takes to help each customer. You’ll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There’s no better place to help people live healthier lives while 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.