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Job Information

UnitedHealth Group Customer Service Representative Lead - Remote in Dallas, Texas

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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 can come true. Already one of the world’s leading Healthcare companies, UnitedHealth 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 UnitedHealth 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.

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. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

  • Extensive work experience, possibly in multiple functions.

  • Experience in all claims platforms - UNET, OHBS Facets, familiar with Cosmos Platform

  • Works independently.

  • Mentors others.

  • Acts as a resource for others.

  • Applies knowledge / skills to complex activities.

  • Demonstrates a depth and breadth of knowledge and skills in own area and is often able to apply these outside of own function.

  • Often acts as a technical resource to others in own function.

  • Anticipates customer needs and proactively identifies solutions.

  • Solves complex problems on own; proactively identifies new solutions to problems.

  • Plans, prioritize, organize, and complete work to meet established objectives.

  • Assist and resolve account management claims issues

  • Assist with repeat caller reporting and provide resolution

  • Acts as a facilitator to resolve conflicts on team; seen as key team member on project teams spanning more than own function

  • Ask appropriate questions and listen actively to identify underlying questions and issues (e.g., root cause analysis)

  • Gather appropriate data and information and perform initial investigation to determine scope and depth of question / issue

  • Identify and coordinate internal resources across multiple departments to address client situations, and escalate to appropriate resources as needed

  • Identify and communicate steps and solutions to caller questions and issues, using appropriate problem - solving skills and established guidelines, where available (e.g., workarounds, descriptions of relevant processes)

  • Offer additional options to provide solutions and positive outcomes for callers (e.g., online access to relevant information, additional plan benefits, workarounds for prescription delays)

  • Make outbound calls to resolve caller questions and issues (e.g., to callers, providers, members)

  • Assist with inbound call volume as needed and requested

  • Drive resolution of caller questions and issues on the first call whenever possible (e.g., first - call resolution, one - and - done)

  • Ensure proper documentation of caller questions and issues (e.g., research conducted, steps required, final resolution)

  • Manage caller conversations appropriately (e.g., provide a good first impression, command attention and respect, maintain

  • professional tone, demonstrate confidence, de - escalate and defuse callers as needed)

  • Maintain ongoing communications with callers during the resolution process to communicate status updates and other required information

  • Maintain focus on caller interactions without being distracted by other factors (e.g., system usage, pop-up alerts, VCC data)

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)

  • 3+ years of claims experience

  • 1+ years of knowledge of medical claims billing ICD-10, CPT, or HCPC codes

  • Currently working in Optum Behavior Health segment

  • Experience using the following claims platforms; UNET, Facets, and COSMOS

  • Ability to work Monday - Friday, 7:00am - 7:00pm

Preferred Qualifications:

  • 1+ years of experience in a leadership role (i.e.: Coach, SME, Supervisor, etc.)

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

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth 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 UnitedHealth 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

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

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $17.12 to $30.34. The salary range for Connecticut / Nevada residents is $18.80 to $33.41. 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.

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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