Patient Service Representative - Orthopedics

Clinical Support Specialist

This position is Onsite. Our office is located at 20 Wall Street Burlington, MA.

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.

Under direct supervision, provides support within a clinical department with primary responsibility for phone coverage and outreach calls, scheduling for the department, greeting patients and monitoring the waiting room, handling the check-out process including follow-up appointment scheduling. Delivers excellent customer service and strengthens the patient/clinician relationship. Works to improve clinical operations through coordination of contact between team clinicians, patients and, when needed, referrals outside the unit. Will also be responsible for managing incoming medical faxes and administrative paperwork (including VNA, FMLA, disability, and PT forms) across North Region sites, with specific oversight of letter management for designated clinics like Burlington and Peabody.

This position is full-time, Monday - Friday. Employees are required to work an 8-hour shift schedule during our normal business hours of 8:30 am - 5:00 pm EST. It may be necessary, given the business need, to work occasional overtime.

We provide paid on the job training aligned to your schedule.

Primary Responsibilities:

Scheduling:

• Books appointments in-person and in MyHealth and relays messages as appropriate. Also handles appointments via phone as needed when calls are made to the department.
• Runs reports from automated appointment confirmation system. Confirms appointments via reminder calls and follows through on cancellations. Reconciles system information with the electronic medical record (EMR) as needed.
• Completes paperwork to obtain information needed for upcoming appointments from outside doctors, hospitals, health or social service agencies, and insurance agencies.
• Makes outreach to patients regarding referrals, scheduling appointments, processing paperwork, and obtaining authorization numbers.
• May develop, edit, or monitor provider appointment templates.
• Actively involved in MyHealth enrollment by encouraging patients to sign up to MyHealth Online.
• Makes outreach to patients to reschedule appointments when the provider will not be available.

Greeting patients/Monitoring waiting room:

• Inform patients on-site if a physician is running late.
• Actively monitors waiting rooms and verifies patient check-ins and kiosks.
• Verifies and updates patient medical information in the EMR, such as confirming demographic information and ensuring the EMR patient data is accurate and up to date.
• May confirm medications, allergies and chief medical complaints following all HIPPA compliance guidelines.

Check-out process:

• As part of check-out process, schedules appointments for patients present in the practice needing a follow-up appointment made. When scheduling, may need to process referrals and communicate with other departments.
• May assist with the checkout function, including distributing the After Visit Summary (AVS) and appropriately booking follow up appointments per department guidelines.

General administrative:

• Sorts and distributes clinician mail and faxes (may be paper or electronic).
• Assists with basic data collection activities for statistical reports or required studies. Ensures data is properly collected and accurate.
• Generates standard correspondence such as letters regarding normal test results or missed appointments.
• Ensures printed documents are up to date for the department (intake forms and phone number sheets).
• Handles patients and third-party requests (e.g., worker's compensation, government and social service agencies) for documentation of medical information, such as health status, worker's compensation related care, and return to work authorizations.
• Completes forms (paper or online) requested by patients including FMLA, Durable Medical Equipment (DME), Patient Transportation (PT-1), and disability forms.
• Obtains prior authorization (e.g. outside imaging, medications, insurance).

Customer Service:

• Answers interdepartmental calls following emergency and department protocols and expediting patient questions.
• Make outreach calls on behalf of the clinicians as needed.
• Provides compassionate front-line customer service and actively works to resolve patient concerns.
• For departments not handled through centralized call centers, screens all incoming patient inquiries

Other:

• Participates in care improvement activities as appropriate, such as Rapid Improvement Events (RIEs), Value Stream Analyses (VSAs), and Managing of Daily Improvements (MDIs).
• Escorts patients to other areas within the practice as needed.
• Participates in special projects and ongoing programs unique to the department.
• May be involved in rollout and implementation of upgrades to the electronic medical record.
• May assist with orienting new staff. Provides back-up coverage for other support staff as necessary.
• Performs all other related duties as assigned

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 equivalent years of work experience
• Must be 18 years of age OR older
• 2+ years of working in medical, healthcare or medical insurance environment
• Experience with computers and Microsoft applications including Microsoft Word, Microsoft Outlook, Microsoft Excel
• Ability to work full-time, Monday - Friday. Employees are required to work an 8-hour shift schedule during our normal business hours of 8:30 am - 5:00 pm EST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Experience working in Orthopedics
• Experience with EMR computer applications
• Working knowledge of medical terminology

Soft Skills:

• Ability to communicate in a professional and appropriate manner.
• Strong interpersonal, customer service, time management, and organizational skills

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 $18 - $32 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 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.