Senior Recovery/Resolution Representative - National Remote - UnitedHealth Group
Dallas, TX 75202
About the Job
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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale.Join us to start Caring. Connecting. Growing together.
When you are in the business of health care, you're in the business of people. At Optum we want every customer experience to be distinctly personal. The challenge is complex. Our customer service teams have a serious responsibility to make every contact informative, productive, positive and memorable for what it says about how much we care.
This role is responsible for providing compassionate and exceptional customer service and issue resolution to our consumers. This role is responsible for handling inbound phone calls from providers and billing companies under minimal supervision while following policies and procedures to meet department productivity and quality goals. Analysts are responsible for resolving a wide variety of inquiries ranging from routine to moderately complex issues independently, only referring to Team Lead and/or Supervisor as needed.
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 7am - 7pm CST. It may be necessary, given the business need, to work occasional overtime.
We offer 2 weeks of paid training. The hours during training will be 8am to 4:30pm, Monday - Friday. Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Assist customers via written (email or fax) and verbal requests from the Provider Inquiry Line and the Fraud Hotline. Incoming calls can be from members and/or Providers questioning claim status, review status, appeal status and/or reporting of fraud within production standards.
- Provide expertise or general support by reviewing case statuses, researching claims platforms and medical record repositories ultimately analyzing where case is in lifecycle to determine next steps in claim process.
- Navigate multiple computer application systems to troubleshoot and resolve inquires while engaging with the customer and documenting interaction.
- Maintains accuracy standards of 97% or greater.
- Maintains adherence standards of 95% or greater.
- Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance.
- Works independently and as part of a team.
- Act as a resource for others.
- Help internal and external customers by being empathetic, demonstrating patience and good listening skills while providing accurate information.
- Manage change in a call center environment, including changes to schedule, business processes and systems/technology.
- Assume additional responsibilities 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.
Required Qualifications:
- High School Diploma / GED (or higher)
- 2+ years of experience within the healthcare, claims, or insurance industries.
- 2+ years of customer service/call center experience.
- Intermediate proficiency with Microsoft Word
- Intermediate proficiency with Microsoft Outlook
- Intermediate proficiency with Microsoft OneNote
- Intermediate proficiency with Microsoft Excel.
- Ability to work Monday – Friday 7:00am – 7:00pm CST. Must be flexible to work any regularly scheduled shift between these hours and must be flexible to work occasional overtime as needed.
Preferred Qualifications:
- Bachelor's Degree (or higher)
- Knowledge of medical terminology.
Telecommuting Requirements:
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
Soft Skills:
- Strong oral communication skills, listening abilities, and problem solving capabilities.
- Ability to maintain a pleasant, courteous and helpful demeanor at all times.
- Ability to diffuse irate or difficult callers while maintaining emotional fortitude for high stress situations.
- Ability to multi-task.
- Positive and energetic attitude.
California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Nevada / New York / New Jersey / Washington / Rhode Island residents is $18.80 - $36.78 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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.
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