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Care Navigator

Company: UnitedHealth Group
Location: Phoenix
Posted on: November 25, 2022

Job Description:

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work. SM This is your chance to take your customer service career to the next level. At Optum, we're changing the way health care works for the better and we want motivated people like you to join us. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work. SM As a Senior Customer Service Representative, 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 of these 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. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 08:30am - 05:00pm. It may be necessary, given the business need, to work occasional overtime. All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Primary Responsibilities:

  • 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 UnitedHealth 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 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)
    • 1+ years of insurance or medical billing experience
    • Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
    • Ability to attend training between the hours of 06:30am - 05:30pm EST during the first six weeks
    • Experience with denial follow-up or accounts receivable Telecommuting Requirements:
      • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
      • Ability to keep all company sensitive documents secure (if applicable)
      • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Preferred Qualifications:
        • 1+ years of Customer Service Representative (CSR) experience OR 1+ years of experience in an office setting, call center setting or phone support role
        • 1+ years of experience in a call setting environment
        • Experience working in a metrics driven environment
        • Knowledge of insurance revenue cycle Soft Skills:
          • Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product
          • Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed

Keywords: UnitedHealth Group, Phoenix , Care Navigator, Other , Phoenix, Arizona

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