Patient Services Representative II

About the role

Pursue your passion and potential. 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.

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 request 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• Reviews and facilitates the updating of missing /outdated information in the patient record, such as demographics, primary care physician selection, and insurance.
• Develops and maintains 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.
• Affords assistance with data collection activities and provides 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.

Qualifications

• High School Diploma/GED
• 2+ years of administrative experience in a medical setting
• Previous EPIC experience preferred
• Strong problem solving and complex patient management skills preferred

Skills

• Able to communicate in a professional and appropriate manner
• Strong interpersonal, customer service, time management, and organizational skills required
• Working knowledge of patient related documents preferred
• Able to use all electronic tools and applications relevant to the performance of the duties of the position, including but not limited to phone, keyboard, computer and computer applications

Benefits

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.)

Pay

The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Benefits

We’re honored to be recognized for our exceptional work culture. Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.

Location

REMOTE IN MA

Hours

Schedule: FT, 40 hrs. Monday - Friday, 8:30am - 5pm

Company

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