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UnitedHealth Group Healthcare Customer Service Representative - Phoenix & Las Vegas in Las Vegas, Nevada

Like you, OptumCare is strong on innovation. And like you, we'll go the distance to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have a chance to make an impact.

Multiple openings in Phoenix and Las Vegas!

As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to make every contact informative, productive and positive for our members and providers. You'll have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases. Bring your skills and talents to a role where you'll have a chance to make an impact.

Primary Responsibilities:

  • Manage administrative intake of members

  • Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and or providers

  • Process incoming and outgoing referrals and prior authorizations including intake, notification and census roles

  • Assist clinical staff with setting up documents and triage cases for Clinical Coverage Review

  • Handle resolution and inquiries from members and providers

  • Other responsibilities as assigned

Required Qualifications:

  • High school diploma or GED

  • 2+ years customer service experience

  • 1+ years work experience in the healthcare / medical field

  • Microsoft Office proficiency

  • Availability to work a shift between the hours of 5am-7pm 5 days per week which could include weekend work (Days off will be two days in a row.)

Preferred Qualifications:

  • Knowledge of ICD-10 and CPT codes

  • Experience working in a call center

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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

Job Keywords: customer service representative, CSR, healthcare, medical, prior authorization, clinical, first call resolution, call center, Phoenix, Las Vegas, Optum, UHG, UHC

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