Sr. Customer Service Quality / Audit Representative - Overland Park, KS or US Telecommute - Full-time

This role is equally challenging and rewarding. The entire customer service operation is reliant on your ability to audit calls and provide feedback to team members, as well as analyzing information to build recommendations. 

Positions in this function are responsible for all aspects of quality assurance within the Customer Service job family. Conducts audits and provides feedback to reduce errors and improve processes and performance. *Employees in jobs labeled with "SCA" must support a government Service Contract Act (SCA) agreement.

This position is required to support the Member Audit team which is responsible for ensuring compliance to operational guidelines. Senior Auditors are seasoned auditors whose primary role includes auditing and providing audit support to the team. This position audits approximately 400 audits monthly. Without the addition of this position we would not meet our production goals which would impact QVC for customer service agents.  Approximately 160 hours of monthly overtime would be required to meet the established goals. Member Audits conducts ~200K audits annually to help ensure adherence to processes driving increased customer satisfaction and NPS across the OptumRx client base.

Systems:RxHD, MyRxAdvisor, Prior Authorizatiion System, RxClaims, Navigator, Qfiniti, Excel

Required Qualifications:

• High School Diploma / GED (or higher)
  

• 2+ years of relevant work experience in the healthcare industry

• 1+ years of experience using Microsoft Excel filtering, sorting and analyzing data

• Ability to work an 8 hour shift between the hours of 6:00 a.m. - 6:00 p.m. CST Monday - Friday with overtime as needed

Preferred Qualifications:

• Bachelor’s Degree or higher

• Quality Auditing experience

• Government program such as Medicare, Medicaid or Medicare Advantage experience

• 2+ years previous Customer Service experience or demonstrated Subject Matter Expert in multiple Member Audit areas

• Experience in customer service call auditing, preferably in health care

• Claims processing experience

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.

If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.  Join us and start doing your life’s best work.SM

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.

Keywords: UnitedHealth Group, UnitedHealth Care, OptumRx, RxHD, MyRxAdvisor, Prior Authorization System, RxClaims, Navigator, Qfiniti, Microsoft Excel