Deskripsi Pekerjaan
Join Optum, a leading healthcare services provider, as a Healthcare Customer Service Representative and make a meaningful impact in the lives of our members. As a vital member of our customer support team, you'll be the first point of contact for individuals navigating their healthcare journeys. This role requires exceptional communication skills and a deep understanding of healthcare systems to resolve inquiries efficiently and compassionately. We offer a dynamic work environment where your contributions directly improve member satisfaction and health outcomes. Optum provides comprehensive training, competitive compensation, and opportunities for career growth within a Fortune 50 company. If you're passionate about healthcare excellence and delivering exceptional customer service, we encourage you to apply and become part of our mission to help people live healthier lives.
Tanggung Jawab
- Handle inbound and outbound customer inquiries regarding health plans, claims, benefits, and billing through phone, email, and chat channels
- Analyze customer issues using diagnostic tools to identify root causes and provide accurate solutions
- Document all interactions in CRM systems while maintaining compliance with healthcare privacy regulations (HIPAA)
- Collaborate with clinical, billing, and claims departments to resolve complex member issues
- Maintain performance metrics including call quality, resolution rates, and customer satisfaction scores
- Continuously update knowledge on healthcare policies, procedures, and system changes
- Escalate unresolved issues to specialized teams while maintaining ownership of the resolution process
Kualifikasi
- Minimum 1 year of customer service experience in healthcare, insurance, or related industry
- High school diploma or equivalent; Associate's or Bachelor's degree preferred
- Proficiency with CRM systems and Microsoft Office applications
- Strong problem-solving abilities and active listening skills
- Ability to navigate multiple systems simultaneously while maintaining accuracy
- Empathetic communication style with diverse patient populations
- Willingness to work flexible shifts including evenings and weekends as needed
- Basic understanding of healthcare terminology and claim processing workflows