Customer Service Representative

Patient Service Representative

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, assists patients through management of incoming calls related to various appointment and medical care needs. The Patient Service Representative plays an integral role as a member of the patients care team by screening all incoming calls and helping complete the request with first call resolution or directing to another member of the interdisciplinary care team. Provides extraordinary customer service and strong problem-solving skills to strengthen the patient/ care team relationship. Manages a high volume of calls most often from a remote setting for a defined service line and is responsible to organize and prioritizes action items following standard work, including allocating tasks to the appropriate member of the care team, and ensuring efforts are coordinated and avoid duplication. Must have clear verbal and written communication skills to ensure the patient and team members understand next steps.

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

We offer up to 12 weeks of paid training. Training will be conducted onsite at 28 Newton St, Southborough, MA 1772.

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 supports 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 details of 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. Uses 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 communicates 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.
• 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 customer service experience
• Experience with computers and Windows based programs
• Basic typing skills
• Must live within a commutable distance to Southborough, MA
• Ability to work full-time, Monday - Friday. Employees are required to work an 8 hour shift schedule during our normal business hours of 8:00 am - 5:00 pm. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Experience working in medical office
• Experience working with Telephones and computers

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 - $29 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.