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UnitedHealth Group Patient Support Center Representative - Laguna Hills, CA in Laguna Hills, California

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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

As a Patient Support Center Representative , you will be responsible for acting as a patient advocate to help resolve patient issues pertaining to claims, benefit referrals, physicians and access. You will also be responsible for managing high - volume of inbound calls (75+ calls per day), enter patient information into information systems, and resolve caller’s issues with outstanding customer service skills. In addition, serve as a liaison between the patient and other departments and Optum sites.

This position is full - time. Employees are required to work any 8-hour shift with rotating schedules during our business hours 8:00am - 5:00pm (7 days / week, 24 hours, year - round) including the flexibility to work occasional overtime, weekends, and holidays based on business need.

We offer 5 weeks of virtual training. The hours during training will be 8:00 AM - 4:30 PM PST (Pacific Standard Time) from Monday - Friday. 100% attendance is required and no holidays will be worked during the training period. Training will be conducted on-site

Primary Responsibilities:

  • Meet the performance goals established for the position in the areas of patient satisfaction, accuracy, quality, and attendance

  • Meet department standards to adherence metric

  • Adherence metric is evaluated daily

  • Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with every internal and external customer

  • Multi - task utilizing double monitors for data entry, phone etiquette, and use of resources while maintaining proper guidelines

  • Provides services to internal and external customers involving the exchange of complex and sensitive information while acting as patient advocate

  • Assists other Patient Support Center Representatives and Supervisors with daily paperwork load as needed to resolve and / or document patient issues

  • Recognizes financial, medical and legal risks based on data collected during customer interactions and follows appropriate procedures

  • Utilizes Optum systems to resolve customer needs such as appointments, authorizations, claims, invoices, eligibility, benefits, appeals, TARs

  • Translates oral information into concise and accurate written documentation per guidelines

  • Assists new or potential members in the choice of PCP and supplies general information about medical group

  • Pages clinicians and assists Telehealth Nurses as necessary (e.g., arranging DME, transportation and HH)

  • Data enters PCP changes into the system and processes paperwork as necessary

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 experience

  • Must be 18 years of age or older

  • 2+ years of experience with working in a customer service - based role

  • Proficiency with using Microsoft suite and other systems, including navigating multiple chat channels within Microsoft Teams

  • Ability to work M-F 8am – 5pm PST schedule during our business hours (7 days / week, 24 hours, year - round) including the flexibility to work occasional overtime, weekends, and holidays based on business need

Preferred Qualifications:

  • 1+ years of experience with working in a healthcare setting

  • Bilingual fluency in English and any of the following languages: Spanish, Russian, Mandarin, Cantonese, Korean, OR others

California Residents Only: The hourly range for this is $16.00 - $28.27 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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