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OptumCare is succeeding at helping people live healthier lives by taking a different approach to health care. OptumCare uses a common sense approach, focused on avoiding jargon, finding more efficient ways to operate, and providing great, in-the-moment service. We provide that service by making sure serving our patients and providers is always the first priority. Each department works from the same central idea: “How does this affect the service we provide?” Because of the extreme commitment to service, OptumCare focuses on recruiting passionate employees who will take advantage of being empowered to provide the highest level of service at each and every step.
The role of the Optum Care Call Center Representative is to ensure patient access to care. This is done by scheduling medical appointments, resolving medication and referral issues, and owning customer service inquiries through to resolution. The employee specifically contributes to organizational/departmental success through:
- Efficient patient access to care
- Responsive phone service
- Patient satisfaction
- Policy/process identification and improvement
- Ongoing quality improvement for customer care interactions
- Schedule, reschedule, and cancel medical appointments using electronic medical record software and following precise scheduling rules
- Verify and update demographic, insurance, and other patient information
- Register new patients for services
- Review patient charts, patient encounter messages, and ambulatory referral orders
- Resolve or escalate customer issues related to:
- Medication refill
- Laboratory services
- Orders for specialty and diagnostic services
- Escalate calls needing clinical triage
- Confirm caller identify and authorization to receive information under HIPAA rules
- Release information only as allowed under HIPAA rules
- Conduct three-way calls with medical translators for patients unable to speak language of employee
- Transfer callers to appropriate department
- Communicate with provider offices via electronic messaging and telephone
- Launch outbound calls as appropriate
- Meet departmental standards for production and quality.
- Meet departmental standards for schedule adherence.
- Mentor new hires and existing staff in the efficient use of call handling best practices designed to ensure accurate and consistent call responses
- Perform other duties as assigned
You’ll be 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.
*** ENGLISH PROFICIENCY & TYPING ASSESSMENT WILL BE REQUIRED AFTER APPLICATION ***
- High School Diploma / GED (or higher)Customer service experience
- 1+ years of customer service experience analyzing and solving customer problems OR 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
- Familiarity with computers and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
- Available to work (40 hours/week) Monday-Sunday. Flexible to work any of our 8 hour shift schedules during our normal business hours of (7:00am to 10:00pm AST) (on a rotating schedule)
- Bilingual in both English and Spanish (English proficiency assessment will be required after application)
- Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.
- Healthcare experience
- Call center experience
- Ability to type 30+ WPM
- Knowledge of medical/healthcare insurance/HMO/PPO/Medicare Plans/benefits and medical terminology
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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, part of the UnitedHealth Group family of businesses, 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 that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and 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.
Job Keywords: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, Optum, health care, office, phone support, San Juan, Puerto Rico, #RPO