Customer Service Representative
is responsible for answering incoming calls from customers while ensuring a high level of customer service and maximizing productivity. The responsibilities of this position are providing customer service support to members, customers, and/or providers. Direct phone-based customer interaction to answer and resolve a wide variety of inquiries. Individuals chosen for this position will answer questions related to pharmacy benefits, mail order and pharmacy assistance calls.
- Answers incoming calls; assists customers/pharmacies/physicians with orders and reorders, benefit eligibility questions and prescription status inquiries. Escalates drug related calls to appropriate pharmacist.
- Assist pharmacies and members on all issues related to processing of pharmacy claims. Determines appropriateness of overriding pharmacy claims edits and error messages.
- Coordinates internal resolution of claims exceptions and other issues.
- Makes outbound calls on prescriptions with hold orders and payment issues.
- May also assist with entering new prescription orders into system.
- Educates customers on benefits, use of plan, formulary, premiums and status of orders, claims or inquiries.
- Other duties as assigned.
Physical Requirements and Work Environment:
- 1 year of customer service experience analyzing and solving customer problems, OR 1 year of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
- An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
- Authorization to work in the United States
- Available to work 40 hours per week anytime within the operating hours of the site
- Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
- Ability to navigate a computer while on the phone
- Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
- Ability to remain focused and productive each day though tasks may be repetitive
OptumRx is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
- Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
- Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable health care solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.
OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do. In the largest and most personal sense, your impact can be greater than even you thought at OptumRx .
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
UnitedHealth Group - 2 years ago
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