Optum ยท 17 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. As a Senior Customer Service Representative, you will deliver exceptional experiences to callers, resolve complex customer issues, and support team members as a subject matter expert.
EducationHealth CareMedicalPharmaceutical
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
Qualification
Required
High School Diploma / GED OR equivalent work experience
Must be 18 years old OR older
1+ years of customer service experience OR experience in a medical office, health care, call-center or office setting analyzing and solving customer problems
Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
Experience translating health care-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
Ability to work fulltime, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30am - 4:00pm. It may be necessary, given the business need, to work occasional overtime
Reside within the state of 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
Proficient conflict management skills including the ability to resolve stressful situations
Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Preferred
Health care experience
Bilingual fluency in English and Spanish
Knowledge of billing/finance and eligibility processes, practices and concepts
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