Patient Service Specialist - UnitedHealth Group

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.SM

Position Details:

• Department: Family Practice

• Schedule: Full time role, Monday through Friday, rotating schedule between the hours of 8:00am-4:30pm and 8:30-5:00pm  Routing schedule every other week

• Location: 225 New Lancaster Road, Leominster, MA 01453

Summary: Performs a full range of administrative support services for clinic/site including the collection of co-payments, scheduling of patients for medical procedures, tests, associated ancillary services, and other related duties; may seek prior authorization and referrals for these services. Answers telephone calls for the department in the assigned department queue and maintains excellent personal agent statistics, like minimal hold time, short average talk times and calls handled. May train others in exemplary processes for both phone and non-phone workflows. Works to resolve patient complaints, and provides education on processes and department scheduling procedures to ensure the highest level of patient/customer satisfaction. 

Primary Responsibilities:

• Verifies and authorizes patient insurance coverage and eligibility. Updates demographics and other patient information including necessary consents and other documents
• Collects, and posts patient co-payments and other outstanding balances. Maintains collection records and makes daily cash deposits as assigned
• Schedules patients accurately, according to department protocols and provider preference
• Completes patient check-out, coordinates scheduling, and other services as directed. Manages and updates the Department Appointment Report
• Provides education, estimate preparation, and other pre-appointment instruction as needed
• Receives and addresses patient-care-related telephone calls. Provides routine information on procedures and standard policies, and refers matters to the appropriate person within the department/site
• Resolves patients’ questions regarding clinic schedules and billing concerns; handles requests for prescription refills, reschedules appointments, etc
• Prepares accurate site deposit
• Accurately and appropriately documents information in the electronic medical record system
• Receives and processes incoming and outgoing insurance referral requests based on department protocol. Collaborates with staff, patients, and providers as needed to complete requests
• Completes follow-up and documentation as needed
• Obtains prior authorizations for various orders (such as sleep studies, cardiac imaging, outside imaging) according to established procedures
• Performs appropriate action regarding No Show, Cancellations, Recall, Waitlist and Reschedule lists, per established guidelines. Follows up with the patient, provider, etc. as needed
• Changes template to alter available slots or single-day availability according to provider preference and department protocol
• Processes personal in-basket and department pool encounter in Epic in a timely and appropriate manner
• In conjunction with department leadership and training, acts as an educator to new PSS staff
• Processes department and provider mail and faxes in a timely and appropriate manner
• Performs chart review in order to satisfy patient requests for form completion, resolve patient complaints or inquiries, or coordinate care related to appointment scheduling
• May escort patients to examination rooms and chaperone patients as required
• Able to identify when patient-related issues need urgent attention and escalate to nursing or provider and/or leadership as needed
• Complies with health and safety requirements and with regulatory agencies such as DPH, etc
• Complies with established departmental policies, procedures, and objectives
• Participates in learning opportunities provided through the learning management system
• Participates in departmental meetings and huddles as directed by department leadership
• Regular, reliable, and predictable attendance is required
• Performs other similar and related duties as required or directed

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.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits

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 higher)

• 1+ year of healthcare or customer service-related experience

• Intermediate level of computer proficiency including MS Word, Excel and Outlook be able to use multiple web applications

Preferred Qualifications:

• 1+ year of experience working in medical front office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays, and maintaining medical records

• Knowledge of Epic EMR software 

Soft Skills:

• Ability to work independently and maintain good judgment and accountability

• Demonstrated ability to work well with health care providers

• Strong organizational and time management skills

• Ability to multi-task and prioritize tasks to meet all deadlines

• Ability to work well under pressure in a fast-paced environment

• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others 

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. 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 

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

#RPO, #RED