Senior Complex Customer Care Representative

This position is National Remote. You’ll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.

Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

As a Senior Complex Customer Care Representative, as part of the Resolution Experience Team, you’ll compassionately deliver an exceptional experience to between 50 to 70 callers per day, always remembering that there is a real person on the other end of the phone who is looking for help, guidance, and support. You’ll also provide support to your team members by serving as a resource or subject matter expert.

Both are opportunities for you to identify and exceed our customer expectations by committing to and building strong relationships internally and externally. At the end, you’ll know you performed with integrity and delivered the best customer service experience making all your customers and team members feel better because they talked to you.

Ability to work full‑time, Monday – Friday. Employees are required to be flexible to work an 8‑hour shift during the hours of 5:00 am – 8:00 pm CST. Mandatory overtime is required during peak season (January‑February) and based on business need and weekends. This will be on the job training and the hours during training will be 5:00 am to 8:00 pm CST, Monday – Friday.

• Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers
• Handle escalated calls, resolving more complex customer issues in a one and done manner
• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Intervene with care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
• Assist customers in navigating United Health Group websites and encourage and reassure them to become self‑sufficient
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow‑up with the member
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
• Provide education and status on previously submitted pre‑authorizations or pre‑determination requests
• Meet the performance goals established for the position in the areas of efficiency, call quality, provider satisfaction, first call resolution and attendance

You’ll rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• High School Diploma / GED
• Must be 18 years of age OR older
• 2+ years of customer service experience analyzing and solving customer problems OR 2+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
• 9+ months of previous call center experience
• First Call Resolution experience
• Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Ability to work full‑time, Monday – Friday. Employees are required to be flexible to work an 8‑hour shift during the hours of…