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Patient Service Specialist

3 months ago

Westford, United States Optum Full time

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 Pediatrics 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.

Hours : 20 hour work week, 4-5 hours per day. Specific work schedule will be based off of clinic needs.

Location : 900 Union St. Westborough, MA

Primary Responsibilities:

  • Verifies, re-verifies and authorizes patient insurance coverage and eligibility utilizing computer-based patient registration/scheduling system. Verifies and updates demographic, insurance, and other patient information. Confirms, collects, and posts patient co-payments and other outstanding balances. Generates and tracks patient encounter forms. Reviews patient encounter forms for completeness and resolves any discrepancies. Batches encounter forms and submit to appropriate billing area
  • Maintains records and makes daily cash deposit as assigned
  • Receives and addresses patient-care related telephone calls. Provides routine information on procedures and standard policies, refers matters to appropriate person within department/site
  • Identifies problem related priorities, and responds to emergency needs by contacting/interrupting physician/provider within guidelines
  • Resolves patients' questions regarding clinic schedules and billing concerns; handles requests for prescription refills, reschedules appointments, etc.
  • Documents appropriate information in computer system. Prepares patient charts. Ensures completeness by locating test results, reminding patients of appointments, including appropriate forms, etc., for patient appointments
  • Updates and maintains Telephone Message System (TMS) in computer system. Follows through on requests. Distributes messages to appropriate provider or others for appropriate action
  • Enters new referrals or ensures that existing referral numbers are linked in the system to ensure managed care requirements
  • Provides patient education regarding managed care plans and referral process. Answers patients' referral questions, concerns, etc. Provides patient with available options
  • Works collaboratively with primary care practices, patients, and specialty practices to process outgoing referrals prior to scheduled visits. Follows up with practices that do not issue a referral or obtain referral on a timely basis
  • Interfaces with staff, providers, and patients regarding denied referrals. Documents information and assists with alternate plan of care, if needed
  • Completes and maintains patient schedules. Schedules and coordinates patient visits, medical procedures for both inpatients and outpatients. Communicates with patients regarding all information related to scheduled appointments
  • Notifies providers, patients and others of changes such as new scheduling, re-scheduling, no-show, emergency appointments and add-ons
  • Maintains recall lists and communicates with patients as appropriate
  • May inform nursing staff or others of laboratory and diagnostic study results; collects and mails test results
  • May escort patient to examination rooms and chaperones patients as required. May process standard and non-standard business office administrative paperwork, such as purchase requisitions, employee time sheets, expense vouchers, etc. Follows-up with personnel outside the medical office to expedite timely action and alleviate, or report delays as appropriate
  • Provides guidance to departmental personnel in medical office on administrative policies and procedures
  • Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
  • 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
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:
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 + years of people interaction experience
Preferred Qualifications:
  • Additional specialized medical secretarial/medical office training
  • Superior customer service skills including the ability to multi-task and resolve patient concerns in a timely manner. Ability to think critically and exercise sound judgment
  • Excellent communication, interpersonal and organizational skills
  • Familiarity with various software applications such as Microsoft Word, Outlook, Excel, etc.
  • EPIC experience

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.

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