Patient Service Representative

Patient Service Specialist

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Reliant Pediatrics & Adult Medicine has an immediate opening for a friendly, patient focused and detail oriented Patient Service Specialist to join our team. The Patient Service Specialist is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service, and adhere to Lean processes. Supports the teams in meeting financial, clinical, and service goals.

Schedule (38.75 hours): Monday through Friday, between the hours of 8:30 am to 5:00pm. The schedule will be determined by the practice manager upon hire.

Location: 5 Neponset Street, Worcester, MA

This individual would be expected to train onsite and work a hybrid-remote model out of our Worcester, MA site with possibility of going 100% in the future. This position follows a hybrid schedule with in-office days for initial training and as needed.

If you reside in Worcester, MA, you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.

Primary Responsibilities:

• Supports a high volume of calls typically for a defined region/dept with back up support to a sister region/dept adhering to department productivity standards set forth by service line
• Screens all incoming patient inquires (through phone, or potentially mychart) to determine whether those inquiries can be appropriately handled by the Patient Service Representative or if they need to be directed to other team members. This includes chart review to identify previous activity that may have occurred related to the call
• Adheres to service line booking guidelines to ensure that clinic utilization is optimized safely and effectively as well as supporting the needs of our patients
• Initiates request for forms, letters, medication renewals, referrals, prior authorizations, and any other administrative needs submitted by patients following standard work determined by service line and answers any corresponding questions. Understands all documents and processes
• Documents detail each call in the patients' electronic medical record using both service line documentation tools as well in addition to free text when appropriate to ensure coordination of care
• Reviews and facilitates the updating of missing /outdated information in the patient record with each call including demographics, primary care physician selection, and insurance
• Effectively deescalates issues with upset patients and practices. Use advanced listening techniques to understand the issue and give patients options as they are available to help resolve and ensure satisfaction. May refer difficult or highly complex phone calls and issues to a supervisor
• Participates in resolving operational difficulties and communicate with supervisor regarding department issues/ problems and opportunities for improvement
• Develops and maintains effective and efficient communication with the patient, interdisciplinary team, department staff, providers, and other agencies
• Participates in problem solving activities, focusing on productivity and quality
• Works with supervisors to ensure continuous improvement of the department
• Attends required team and/or regional meetings to learn new workflows and stay connected with teams working in a remote environment
• Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations
• Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance
• Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents
• Written Communications: Ability to summarize and communicate moderately complex information in varied written formats to internal and external customers
• Oral Communications: Ability to comprehend and communicate complex verbal information to medical center staff, patients, families, and external customers
• Knowledge: Ability to demonstrate full working knowledge of standard work, practices, procedures, and policies with the ability to use them in varied situations
• Teamwork: Ability to work collaboratively with interdisciplinary teams consisting of remote and onsite staff to improve the operations of immediate work groups by offering ideas, identifying issues, and respecting team members
• Complies with health and safety requirements and with regulatory agencies
• Complies with established departmental policies, procedures, and objectives
• Enhances professional growth and development through educational programs, seminars, etc.
• Attends a variety of meetings, conferences, and seminars as required or directed
• Regular, reliable and predictable attendance is required
• Performs other similar and related duties as required or directed

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at:

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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 healthcare or customer service-related experience
• Intermediate level of proficiency with Computer-Based Navigation (ability to navigate multiple screens, document electronically, typing while speaking on the phone & familiarity with technology)
• Ability to work onsite as needed and work remotely from home

Preferred Qualifications:

• 1+ years of experience working in a medical front office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays and maintaining medical records
• Proficiency in Microsoft Office (Word, Excel and Outlook)
• Knowledge of Epic EMR software
• Ability to learn new software (EPIC/EMR) and flexibility to attend new hire training

Soft Skills:

• Ability to work independently and maintain good judgment and accountability
• Ability to prioritize tasks to meet all deadlines
• Ability to work well under pressure in a fast-paced environment
• Demonstrated ability to work well with health care providers
• Strong organizational and time management skills
• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health