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 Representative 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.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to work an 8 hour shift schedule between the hours of 8:00 am to 5:00pm. The schedule will be determined by the practice manager upon hire.

We provide up to 6 weeks of training. This individual would be expected to train onsite and work an office-based model out of our Worcester, MA site with possibility of going 100% in the future.

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

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 equivalent work experience
• Must be 18 years of age OR older
• 1+ years of recent experience working in an office setting (preferably in a medical setting, including answering a high volume of phone calls and working with either EPIC or any similar EMR)
• Intermediate level Proficiency in Microsoft Office. Microsoft Word (create edit save) Microsoft Excel (view, sort, filter) and Microsoft Outlook
• Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to work an 8 hour shift schedule between the hours of 8:00 am to 5:00pm. The schedule will be determined by the practice manager upon hire

Preferred Qualifications:

• Proficiency in Microsoft Teams in a remote setting

Soft Skills:

• Ability to work independently and maintain good judgment and accountability
• Ability to prioritize tasks to meet all deadlines
• Demonstrated ability to work well in a remote environment
• Ability to work well under pressure in a fast-paced environment
• 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

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 salary for this role will range from $16 - $29 hourly 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 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.

UnitedHealth Group 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.

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