Specialist at UnitedHealth Group in Overland Park, KS
You will be redirected to UnitedHealth Group's preferred application process.
Call Resolution Specialist - Remote
Energize your career with one of Healthcare's fastest growing companies.
You dream of a great career with a great company - where you can make an impact and help people.
We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, United.
Health Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make United.
Health Group a Fortune 10 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance. As a Call Resolution Specialist for Optum Infusion Pharmacy, you play a critical role in creating a quality experience for the callers you connect with. This includes the initial triage and administrative intake of members, as well as interactions with hospitals, doctors, and clinical teams. Every interaction gives you that opportunity to improve the lives of our customers and exceed their expectations. You'll spend the majority of your day fielding incoming calls, helping answer questions, and most importantly resolving patient's concerns with a "one touch resolution" method. Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 7:00am
- 7:00pm. It may be necessary, given the business need, to work occasional overtime. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Training will be conducted virtually from your home.
* All Telecommuters will be required to adhere to United.
Health Group's Telecommuter Policy.
Primary ResponsibilitiesAnswer 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 Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely documentation for the member Manage the concerns of members or the admission/discharge information post notification Relay status information on the referral process, notifying patients of timing for their services May act as a resource for others Review and research incoming inquiries from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifiying the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits) Ensure that the proper actions are applied to each call by using the appropriate processes and procedures (eg. Quality monitoring guidelines, NP
S surveys) Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction and attendance Work is frequently completed without established proceduresYou'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.
Required QualificationsHigh School Diploma / GED (or higher) 2+ years of experience analyzing and solving customer problems 2+ years of experience working in the health care industry 2+ years of experience working with medical terminology 1+ years of experience working in a Call Center Ability to work any 8 hours shift from 7:00am
- 7:00pm, Monday - Friday with the possibility of mandatory overtime to include weekends If you need to enter a work site for any reason, you will be required to screen for symptoms using the Protect.
Well mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar United.
Health Group-approved symptom screener. When in a United.
Health Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders.
Telecommuting requirements: Dedicated work area established that is separated from other living areas that provides information privacy Ability to keep all company sensitive documents secure (if applicable) Residing in a location that can receive a high-speed internet connection (additional information on United.
Health Group approved internet providers and restrictions will be provided)
Preferred QualificationsExperience working with health care insurance Clerical or administrative support background or experience working in a call center environment Experience working with Medicare and/or Medicaid Services.
SkillsDemonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments) Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member Proficient problem-solving approach to quickly assess current state and formulate recommendations Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon Flexibility to customize approach to meet all types of member communication styles and personalities Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience.
UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non-clinical workforce transitioned to a work at home (remote) status.
We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html.
OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do. If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.
Join us and start doing your life's best work.
SMColorado Residents Only: The hourly range for Colorado residents is $17.12 to $30.34 Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance. Military & Veterans find your next mission:
We know your background and experience is different and we like that. United.
Health Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the United.
Health Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military.
Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet.
Diversity creates a healthier atmosphere: United.
Health 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. United.
Health Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Keywords: OptumRx, UHG, United.
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You will be redirected to UnitedHealth Group's preferred application process.