Patient Service Representative II

Optum; Boston (MA); Hybrid; USD 25,000 - 44,000; Full time

Benefits offered by this job

Paid Time Off

Medical Plan options

Dental, Vision, Life & AD&D

401(k) Savings Plan

Education Reimbursement

Employee Discounts

Employee Assistance Program

Voluntary Benefits

Job summary

Optum is seeking a Patient Service Representative II to support access for patients in a fast-paced call center environment. You will handle inquiries, assist with appointments, and collaborate with clinicians to improve patient flow and satisfaction.

Ideal candidates bring 2+ years of clinical or medical call center experience, strong communication, and a commitment to privacy. The role offers telecommuting options for those near MA offices.

Qualifications

• High School Diploma or GED required.
• 2+ years of clinical experience and/or medical call center experience.
• Preferred EMR experience (EPIC) and familiarity with patient documents.
• Strong problem solving and compassionate patient management skills.

Responsibilities

• Answer incoming patient inquiries via phone, online messages, or other channels.
• Determine whether issues can be handled by a Patient Service Representative or escalated.
• Provide excellent customer service and maintain patient-focused communication.
• Assist with appointment management and care coordination per department guidelines.
• Protect patient privacy and comply with HIPAA and privacy policies.

Skills

Clinical experience

Medical call center experience

Education

High School Diploma/GED

Job description

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

Under direct supervision, plays an expanded and advanced level role in the creation of superior access for patients. Duties include but are not limited to handling incoming patient inquires and assisting patients in the management of appointments/care. Through a variety of support duties that facilitate the work of an interdisciplinary coordinated care delivery model, the Patient Service Representative plays an integral role in the support of our patients. As a level II representative, utilizes advanced skill set to perform all duties of the Patient Service Representative I and serves as resource and mentor for lower-level representatives. Handles the more complex issues arising through incoming calls. Provides extraordinary customer service and strong problem-solving skills to strengthen the patient/clinician relationship. Must have clear verbal and written communication skills to ensure improve patient access.

Schedule:

Monday - Friday, 8:30am - 5pm EST

Location:

If you are located within a commutable distance (~30 minutes) to an Atrius office that is nearest to you in MA or surrounding locations (RI or NH), you will enjoy the flexibility to telecommute* as you take on some tough challenges. Must be willing and able to pick up technology from an Atrius office after hire.

Department:

Orthopedics, Hand, & Podiatry (Call Center)

Primary Responsibilities

• Maintains a higher degree of technical expertise than Patient Services Representative I and serves as role model to Patient Services Representative I's. Able to problem-solve and serve as a resource to other Patient Services Representatives
• Screens all incoming patient inquires (through phone, online/medical record message, or other means) 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
• Courteous, friendly, problem solver with customer service, patient focused communication
• Acts as a role model for other support staff and demonstrates a high level of competency in Patient Service Representative responsibilities
• Proactively identifies issues and works to resolve them in areas involving patient satisfaction, patient flow, and compliance with procedures and guidelines. Advocates for patients as appropriate
• Identifies and assists in resolving operational difficulties and communicates with supervisor regarding department issues and problems as necessary. Demonstrates a high level of competency when handling difficult phone calls and dealing with complex issues
• Initiates requests for forms, letters, medication renewals, referrals, prior authorizations, and any other administrative needs submitted by patients and answers any corresponding questions. Understands all documents and processes. Reviews and facilitates the updating of missing /outdated information in the patient record, such as demographics, primary care physician selection, and insurance
• Develop and maintain effective and efficient communication with the patient, interdisciplinary team, department staff, providers, and other agencies
• Reviews department appointment schedules to ensure that clinic utilization is optimized and effectively supports the needs of the clinics as well as the needs of the patients
• Assists with data collection activities and provide appropriate follow-up for statistical reports or required studies, ensuring data is properly collected and accurate (e.g. no-show reports, telephone statistics)
• Receives escalated issues and determines appropriate action and/or works with clinical team for decision
• Effectively deescalates issues with upset patients and practices. Uses advanced listening techniques to understand the issue and give patients options as they are available. Escalates to supervisors only as needed
• Supports, mentors and trains lower-level assistants
• Participates in problem solving activities, focusing on productivity and quality. Works with supervisors to ensure continuous improvement of the department
• Participates in special projects and ongoing programs unique to the department
• May represent department on groups and teams related to upgrades of the electronic medical record
• Performs functions of a Patient Service Representative I
• Performs other duties as assigned
• Accesses only the minimum necessary protected health information (PHI) for the performance of job duties. Actively protects the confidentiality and privacy of all protected health information they access in all its forms (written, verbal, and electronic, etc.) taking reasonable precautions to prohibit unauthorized access. Complies with all Atrius Health and departmental privacy policies, procedures and protocols. Follows HIPAA privacy guidelines without deviation when handling protected health information

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.)

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
• 2+ years of clinical experience and/or medical call center experience

Preferred Qualifications

• Previous EMR experience (EPIC preferred)
• Working knowledge of patient related documents

Soft Skills

• Strong problem solving and complex patient management skills
• Able to communicate in a professional and appropriate manner
• Strong interpersonal, customer service, time management, and organizational skills

Telecommuting Requirements

• Reside within commutable distance to the nearest Atrius location to you
• 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 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 $18 to $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.

#RPO #GREEN