Optum ยท 12 hours ago
Senior Customer Service Representative
United States
Full-time
Remote
Mid, Senior Level
$17.74/hr - $31.63/hr
1+ years expOptum is a global organization that delivers care aided by technology to help millions of people live healthier lives. The Senior Customer Service Representative will be responsible for addressing customer concerns, functioning as a liaison between physicians and health plans, and ensuring timely resolution of issues while maintaining quality standards. This role requires effective communication and interpersonal skills to foster relationships and support organizational goals.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Occasional shadowing/training of newly hired staff
Receives and records customer concerns via phone. Acts to resolve concerns in accordance for corporate guidelines and standards for all areas of claims, authorizations and IPA functionality
Functions as liaison between physician, health plan, and IPA staff
Ability to interpret provider and health plan contracts to ensure accurate responses to calls
Log issues into the Customer Service Tracking database that require resolution and/or follow-up
Plan and organize workload to ensure efficient and timely resolution of issues
Respond to callers with the resolution of issues in a timely manner in accordance with the guidelines set by the department
Participates in telephonic surveys as required by management
Follow and support the guidelines set by the department and organization to ensure overall goals are met
Maintain minimum standards for the department for quality and quantity of calls received
Foster interpersonal relationships, showing empathy and understanding towards staff, protecting individual self-esteem. Understand own impact on others; interact effectively with peers, subordinates, and supervisors
Any other assigned duties as delegated by the Customer Service Supervisor
Qualification
Required
High School Diploma / GED or equivalent work experience
Must be 18 years of age OR older
1+ years of experience in Medicare and HMO environment
1+ years of claims processing or claims customer service experience
1+ years of authorization/referral processing experience
1+ years of customer service experience
Experience with spreadsheet applications such as Excel and/or Access
Experience with and knowledge of standard billing practices
Experience interpreting provider and health plan contracts
Experience using Windows programs including Microsoft word, Outlook and Excel
Ability to work 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 7:30 am - 4:00 pm PST. It may be necessary, given the business need, to work occasional overtime
Reside within California
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
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
Company data provided by crunchbase