Patient 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 have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:30am - 5:00pm. It may be necessary, given the business need, to work occasional overtime.

We offer 4-6 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities:

• Supports a high volume of calls typically for a defined region/department with back up support to a sister region/department 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 guideline ensuring safe and optimized clinic utilization that 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 including 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 as 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, communicating with supervisors 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.

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 customer service experience in a clinical setting
• Must be 18 years of age OR older
• 1+ years of customer service experience in a clinical setting
• Electronic Medical Record (EMR) experience
• Ability to work fulltime, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:30am - 5:00pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Experience in an Automatic Call Distribution (ACD) call center setting
• EPIC experience
• Nephrology experience

Telecommuting Requirements:

• Reside within commutable distance to the office at WORCESTER-100 FRONT STREET
• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

All employees working remotely 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 - $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 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.