Customer Service Representative – Cooperstown, NY

Cooperstown, New York
UnitedHealth Group
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.

The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it’s reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you’ll help understand and overcome errors in claims processing. You’ll have all the tools and backing you need to help manage subrogation files, negotiate settlements, and ensure adherence to compliance policies. All the while, you’ll be building your career with a leader and reaching for the highest levels of performance as you do your life’s best work. SM

This is a challenging role with serious impact. You’ll need to sort through complex situations to understand and clarify where errors happened or where they may continue to happen. It’s a fast – paced environment that takes focus, intensity, and resilience.

This position is full – time (40 hours / week), Sunday – Thursday. Employees are required to work any shift between the hours of 6:00 AM – 6:00 PM CST (Central Standard Time) including the flexibility to work occasional overtime and weekends based on business need. Our office is located at 31 BEAVER STREET, COOPERSTOWN, NY, 13326. We offer 4 weeks of onsite training.

Primary Responsibilities:

• Answers inbound phone calls daily while providing a high – quality patient / caller experience
• Schedules, reschedules and cancels appointments
• Registers new patients, verifies patient demographics and health insurance, updates patient information in designated databases
• Responds to general information requests and / or inquiries from patients, physicians, medical offices and other callers
• Communicates effectively and in a professional manner
• Transfers non – applicable calls to appropriate internal departments to ensure patient satisfaction
• Processes all work related responsibilities in an efficient, timely and accurate manner
• Consistently develops and maintains a working knowledge of all medical specialties as they relate to the position
• Accurately transmits detailed written communications in a clear and concise manner to site staff and physicians via our medical communication platforms
• Adheres to system guidelines, policies and procedures while meeting the needs of all callers encountered throughout the workday
• Displays proficiency in the technological areas required to perform daily primary responsibilities
• Collaborates with Contact Center team and consistently performs all duties at the highest – level during crisis, whether individually or as a team
• Performs additional general responsibilities as assigned or required
• Basic Call Handling
  • Will always answer with the appropriate greeting on the first ring unless on another call
  • Speaks in a confident, friendly, pleasant tone, with good diction and clear enunciation, displays a “smile” in their voice, thus projecting a positive image
  • Displays an appropriate and professional attitude
  • Follows the Bassett Healthcare Network and Contact Center Telephone courtesy standards
  • Values others opinions even though they may be different from their own
  • Practices active listening and uses appropriate fact – finding questions, refrains from blind transfer of calls
  • Will always follow established written and electronic protocols
  • Takes control of call using solid customer service skills; refrains from “overtalk” and giving advice
  • Will utilize all tools available to process calls, including but not limited to directory, I – series, protocols, point people, help phone, Epic decision trees, Contact Center management
  • Will follow all service – specific and online protocols, as well as specials and Client Information pages
  • Processes calls after normal business hours, holidays, meetings, lunch coverage, etc. for Cooperstown campus, clinics, specialty care providers, and several regional sites
  • Accesses Epic to verity appointments for patients; all patient demographics will be verified and updated accordingly in the Epic system
  • Will process appointment scheduling calls in a professional manner
    • Department – specific protocols will be adhered to for each type of call
  • Insurance coverage and co – pay are verified and updated in Epic using the real – time eligibility feature
    • Appropriate guarantor account created in the instance of a new BMH patient
  • Processes Open Referrals according to protocol
  • Processes Cyclical, Linked, or Coordinated appointments according to protocol
  • Will take complete, accurate and understandable message for each call with emphasis on correct spelling
  • Message add to be made when needed; message is to be expanded and distributed per protocol
  • Will set repeats and message adds when necessary
  • Prescription refill requests are processed according to protocol
  • Emphasis is placed on accuracy and correct spelling; abbreviations are not used
  • Always maintain patient confidentiality
• Quantitative Measures
  • Meets or exceeds the Contact Center performance standards for the following call handling quantitative measures:
    • On – time: 90% or higher
    • Time to Answer: 90% or higher on first ring
    • Disconnect Time: 24 seconds on average
• Emergency Call Handling – (Codes and Team Activations) – Communication Center Specific
  • Will process all code calls and team activations according to the appropriate protocol
  • Will follow protocol for all Overhead Announcements
  • Will complete all pertinent information and take complete and accurate message tickets per protocol
  • Will activate any pagers listed in the protocol or contact appropriate personnel via other methods as dictated in protocol
  • Will make any necessary overhead announcements per protocol
  • Will process an “All Clear” when notified appropriately
  • Will contact a member of Contact Center management with any issue or concern on any code or team activation
  • Will contact 911 and other emergency authorities according to protocol
  • Will process nurse triage and secretarial calls in a professional manner
• Monitoring Facility Alarm Systems – Communication Center Specific
  • Will monitor and respond to all Facility Alarms, including but not limited to:
  • Alarm Panel, Scanner, Security Radio, Baby Alarm, Weather Radio, Temperature Monitoring System, Strongline (Employee Assistance), Call Boxes
  • Will document appropriately (i.e., account 59 or 69)
  • Will process according to protocols
• Electronic Medical Record – Communication Center Specific
  • Will utilize Epic view access to obtain minimum information needed to accurately complete the job
  • Will act as initial “Help Desk” for MyBassett Health Connection to assist callers with issues or concerns on their MyBassett Health Connection accounts
  • Will activate MyBassett Health Connection accounts for patients
• Department Specific Tasks
  • Solid understanding of the Amtelco call handling system; will contact a member of Contact Center management with any issue or concern
  • Processes additional calls (i.e., Pre – registration calls, logistics, etc.) as designated by a supervisor
  • Attends assigned Contact Center daily huddle meetings
  • Performs other duties as requested and observed by supervisor or manager
  • Status changes for pagers are documented in account 2525 and processed accurately in a timely manner
  • Contact Center on call will be notified of any issue or concern – Communication Center Specific
  • On Call changes are documented in account 55 and processed in a timely manner; Contact Center on call will be notified of any issue or concern – Communication Center Specific

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 higher)
• 1+ years of experience in a customer service, communications, OR call center environment
• Familiarity with using Microsoft Office Applications (Microsoft Word, Microsoft Excel, and Microsoft Outlook)
• Flexibility to work a variety of shifts (40 hours / week)
• Ability to work any shift between the hours of 6:00 AM – 6:00 PM CST (Central Standard Time) from Sunday – Thursday including the flexibility to work occasional overtime and weekends based on business need

Preferred Qualifications:

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