Customer Service Representative

This position is Remote in Eastern, Central, OR Mountain Time Zones. You will have the flexibility to work remotely
* 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 inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

This position is full-time, Monday-Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm PST. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of paid training. The hours during training will be 8am to 5pm PST, Monday - Friday. Training will be conducted virtually from your home.

Primary 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)

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 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

* Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications

* Health care experience with primary / specialty appointments OR health plans

* Ability to work during our normal business hours of 8:00 am - 5:00 pm PST from Monday-Friday. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

* Experience working in EPIC system

* Experience working in a remote position

* Bilingual fluency in English and Spanish

Telecommuting Requirements:

* Reside within Eastern, Central or Mountain Time Zones

* 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…