Senior Customer Service Representative - San Antonio, TX

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.

The Senior Customer Service Representative will compassionately deliver an exceptional experience to between 50 to 70 callers per day. Responsible for conducting intake services from internal and external correspondence through telephonic inquiry. In addition to conducting telephonic outreach services, this position assists in benefits redetermination status for DSNP patients. Supports the Economic Security Assistance Department in assisting low-income Medicare beneficiaries with the qualification and application process for Medicare Savings Programs and redetermination.

This position is full-time (40 hours/week), Monday - Friday. Employees are required to work during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. Employees are required to work some days onsite and some days from home. Dress code is business casual.

We offer on-the-job training. The hours of training will be based on your schedule or will be discussed on your first day of employment.

If you are within a commutable distance to the office at 19500 W Interstate 10, San Antonio, TX 78257, you will have the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

• Conducts intake services from incoming correspondence, telephonic inquiries, and telephonic outreach activities. Analyses and assesses state Medicaid eligibility criteria for enrollment in Medicare Savings Programs and Health DSNP eligibility and status
• Research complex issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues
• Maintains assigned caseload and accurately inputs and maintains a contact database
• Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member customers
• Communicates effectively with elderly individuals and state and government personnel as well as other internal departments
• Handle escalated calls, resolving more complex member issues in a one and done manner
• Answer incoming phone calls from members and identify the type of assistance the member needs
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Educate members on the State eligibility process and keeping their certification current
• Always maintains customer and organization confidentiality
• Performs all other related duties as assigned

In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors' offices. At WellMed our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000+ older adults. Together, we're making health care work better for everyone.

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 Customer Service Representative (CSR) experience
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Proficient in Microsoft Word (creating and editing documents), Microsoft Excel (creating and editing tables), and Microsoft Outlook (email and calendar management)
• Ability to work Monday - Friday, during our normal business hours of 8:00am - 5:00pm, including the flexibility to work occasional overtime, based on the business need

Preferred Qualifications:

• Bilingual fluency and proficiency in English and Spanish
• 1+ years of experience with adult Medicaid programs and CMS guidelines

Telecommuting Requirements:

• Reside within a commutable distance to the office at 19500 W Interstate 10, San Antonio, TX 78257
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

• Ability to demonstrate customer service and proper telephone etiquette
• Solid listening, critical thinking, decision making, telephone, customer service, and problem-solving skills
• Strong / Solid oral and written communication skills

Physical and Work Environment:

• Ability to sit for extended periods of time

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The hourly range for this role is $16.88 to $33.22 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.

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.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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

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