Patient Care Support Specialist

2 weeks ago

Auburn, Massachusetts, United States Optum Full time

Key Responsibilities:
Ensures verification and re-verification of patient insurance coverage and eligibility through a computerized patient registration and scheduling system.
Updates and maintains demographic, insurance, and other essential patient data.
Collects, confirms, and processes patient co-payments and outstanding balances.
Generates and monitors patient encounter documentation.
Reviews encounter forms for accuracy and resolves discrepancies as needed.
Organizes and submits encounter forms to the relevant billing department.
Maintains accurate records and performs daily cash deposits as assigned.
Handles patient-related telephone inquiries with professionalism.
Provides standard information on procedures and policies, directing complex matters to the appropriate personnel.
Identifies urgent patient needs and communicates with healthcare providers as necessary.
Addresses patient inquiries regarding clinic schedules and billing issues; manages requests for prescription refills and appointment rescheduling.
Documents pertinent information in the patient management system.
Prepares and organizes patient charts, ensuring all necessary information is included for appointments.
Updates and manages the Telephone Message System (TMS) within the patient management software.
Follows up on requests and distributes messages to the appropriate healthcare providers for action.
Enters new referrals and ensures existing referral numbers are linked to meet managed care requirements.
Educates patients about managed care plans and the referral process.
Responds to patient questions and concerns regarding referrals, providing available options.
Collaborates with primary care and specialty practices to facilitate outgoing referrals before scheduled visits; follows up on referrals not issued timely.
Communicates with staff, providers, and patients regarding denied referrals, documenting necessary information and assisting with alternative care plans when needed.
Manages patient schedules, coordinating visits and medical procedures for both inpatient and outpatient settings; communicates all relevant information to patients regarding appointments.
Notifies providers and patients of any changes in scheduling, including new appointments, rescheduling, and emergency visits.
Maintains recall lists and communicates with patients as appropriate.
May inform nursing staff or others of laboratory and diagnostic results; collects and sends test results as needed.
May escort patients to examination rooms and provide necessary support.
May handle standard and non-standard administrative paperwork, such as purchase requisitions and expense reports.
Follows up with external personnel to expedite actions and report any delays.
Provides guidance to departmental staff on administrative policies and procedures.
Adheres to health and safety regulations and complies with regulatory standards.
Follows established departmental policies and objectives.
Engages in professional development through educational programs and seminars.
Participates in various meetings and conferences as required.
Regular attendance and punctuality are essential.
Performs other related duties as assigned.

Required Qualifications:
High School Diploma or GED (or higher).
Minimum of 1 year of experience in healthcare, customer service, or administrative roles.

Preferred Qualifications:
Additional training in medical secretarial or medical office practices.
Familiarity with software applications such as Microsoft Word, Outlook, and Excel.
Experience with EPIC systems.

Soft Skills:
Exceptional customer service abilities, including multitasking and timely resolution of patient concerns.
Strong critical thinking and sound judgment skills.
Excellent communication, interpersonal, and organizational capabilities.

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