Sr. Complex Customer Care Representative – Concord, CA

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.

 

Sr. Complex Customer Care Representative is responsible for processing patient concerns, financial assistance applications, and customer service calls. This position will manage and interact with patients and operational departments to address and resolve concerns arising from billing and collections process within the Customer Service department of the Single Business Office for John Muir Health.

 

This position is full-time, Monday – Friday. Employees are required to work our normal business hours of 8:00am – 4:30pm. Our office is located at 5003 Commercial Circle, Concord, CA.

 

This will be on-the-job training and the hours during training will be 8:00am to 4:30pm, Monday – Friday. 

 

Primary Responsibilities:

• Patient/Customer Experience: Makes oneself fully available to the patient/ customer, particularly if the patient/customer is going through a critical or challenging period that requires JMH support. Takes actions beyond normal expectations by providing superior quality of care and service. Prevents problems from re-occurring through patient/customer education and/or by addressing faulty procedures or improving upon current work.
• High Reliability: Demonstrates an open, personal and team commitment to safety and fosters highly reliable performance. Consistently uses professional, accurate, clear, and timely verbal, written, and electronic communication to the patient or customer and other team members. Thinks things through to ensure actions are the best possible. Focuses on details at hand to avoid unintended errors. Reports concerns and errors using department-approved tools and processes.
• Service Recovery: Demonstrates the ability to use the “HEART” model in performing service recovery. Consistently uses the steps of:
• Hear the Story
• Empathize
• Apologize
• Respond
• Thank
• Patient/Customer Communication: Asks a series of clarifying questions to get to the root of a need, situation, problem, or opportunity. Calls on others to get their perspective, background knowledge, information, and experience. Anticipates and prepares for questions, reactions, objections, or misunderstanding when key assumptions are not shared. Adapts communication style and medium to suit both the message and the audience. Contacts patient to schedule visit and keeps patient updated of changes to schedule.
• Quality & Performance Improvement: Adheres to standard policies and procedures. Strives to surpass past performance levels. May focus on new or more precise ways of meeting performance objectives than those set by management. Participates in Quality improvement processes.
• Teamwork: Works well with others. Collaborates effectively by keeping team members informed about developments or action that may affect them or the team. Participates in team discussion to ensure that patient care/customer service is delivered in an effective and collaborative manner. Demonstrates commitment to JMH’s Core Values.
• Take escalation calls and covering phone team as needed.

Patient Accounts

• Monitor and resolve patient financial applications within departmental timeframes, guidelines, and procedures.
• Refer patient charge inquiries or care concerns to appropriate clinical staff, when appropriate.

Customer Service

• Monitor and resolve patient concerns, received in writing, escalated by Customer Service Specialists, or arise from communication with vendors.
• Coordinate with appropriate internal departments and ensure timely follow-up and resolution to patient concerns and inquiries.

Department Operations

• QA: Track all department notification issues for quality assurance.
• Improvement: Identify opportunities for system and process improvement and submit to management.
• Customer Service/Liaison: Act as Customer Service Specialist I as needed upon Supervisor request.
• Work Assignment – Customer Service: Consistently meet the current productivity standards by managing a high number of patient issues and financial assistance applications and applying accurate and complete independent problem-solving skills to personally resolve patient questions.
• Leadership Functions – Goals and Objectives
• Provide individual contribution to the overall team effort of achieving the department AR goal.

Confidentiality

• Competency: Demonstrate knowledge of John Muir Health System Health Insurance Portability and Accountability Act (HIPAA) privacy standards and ensure compliance with system Protected Health Information (PHI) privacy practices.
• Joint Commission: Complies with all Health Insurance Portability and Accountability Act (HIPAA) and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards as well as the rules and regulations for any outside government regulatory agency, including the processing of appropriate forms and paperwork.

 

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
•  Must be 18 years of age OR older
• 1+ years of healthcare industry experience
• 1+ years of medical collections experience
• 6+ months experience with resolving and analyzing customer concerns
• Knowledge of PC applications including ability to create and modify spreadsheets, documents, and emails within Microsoft Office: Microsoft Excel (create and edit data in spreadsheets), Microsoft Word (create and edit documents), and Microsoft Outlook (email and calendar management)
• Basic knowledge of medical terminology
• Ability to work 100% onsite at John Muir Health – 5003 Commercial Circle Concord, CA
• Ability to work our normal business hours of 8:00am – 4:30pm PST, Monday – Friday

 

Preferred Qualifications:

• 2+ years of Revenue Cycle and Billing follow up experience
• Bilingual fluency in English and Spanish or any other language
• 1+ years of experience with EPIC platform

 

Soft Skills:

• Strong written & verbal communication skills 

 

The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. 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.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

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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