Note: The job is a remote job and is open to candidates in USA. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Customer Service Representative role involves addressing caller questions and issues, coordinating resources, and ensuring effective communication to provide solutions and improve health outcomes.
Responsibilities
- Demonstrate understanding of internal / external factors that may drive caller questions / issues (e.g., recent plan changes, mass mailings, call directing / rerouting, weather emergencies)
- Ask appropriate questions and listen actively to identify underlying questions / issues (e.g., root cause analysis)
- Gather appropriate data / 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
- Proactively contact external resources as needed to address caller questions / issues (e.g., providers, labs, brokers)
- Utilize appropriate knowledge resources to drive resolution of applicable questions / issues (e.g., websites, CRM tools, Onyx, Siebel, knowledge bases, product manuals, SharePoint)
- Identify and communicate steps / solutions to caller questions / issues, using appropriate problem-solving skills and established guidelines, where available (e.g., workarounds, descriptions of relevant processes)
- Offer additional options to provide solutions / 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 / issues (e.g., to callers, providers, brokers, pharmacies)
- Drive resolution of caller questions / issues on the first call whenever possible (e.g., first-call resolution, one-and-done)
- Ensure proper documentation of caller questions / issues (e.g., research conducted, steps required, final resolution)
Skills
- High School Diploma / GED OR equivalent work experience
- Must be 18 years of age OR older
- 1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
- Health care experience with primary / specialty appointments OR health plans
- Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
- Ability to work any of our full time, 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm PST from Monday - Friday, including the flexibility to work occasional overtime given the business need
- Bilingual fluency in English and Spanish
- Experience with working in EPIC system
- Experience with working in a remote position
Benefits
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
Company Overview