Patient Service Specialist

7 days ago

Worcester, Massachusetts, United States UnitedHealth Group Full time
Job Summary

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.

Key Responsibilities
  • Verify patient insurance coverage and eligibility utilizing computer-based patient registration/scheduling system
  • Update demographic, insurance, and other patient information
  • Collect and post patient co-payment and other outstanding balances
  • Generate and track patient encounter forms; review patient encounter forms for completeness and resolve any discrepancies
  • Maintain records and make daily cash deposit as assigned
  • Address patient care related telephone calls. Provide routine information on procedures and standard policies, refer matters to appropriate person with department/site
  • Identify problem related priorities and respond to emergency needs by contacting/interpreting physician/provider within guidelines
  • Resolve patients' questions regarding clinic schedules and billing concerns; handle requests for prescription refills, reschedules appointments, etc
  • Document appropriate information in computer system
  • Prepare patient charts
  • Ensure completeness by locating test results, reminding patients of appointments, including appropriate forms, etc., for patient appointments
  • Update and maintain Telephone Message System (TMS) in computer system. Follow through on requests. Distribute messages to appropriate provider or others for appropriate action
  • Enter new referrals or ensure that existing referral numbers are linked in the system to ensure managed care requirements
  • Provide patient education regarding managed care plans and referral process. Answer patient's referral questions, concerns, etc. Provide patient with available options
  • Work collaboratively with primary care practices, patients, and specialty practices to process outgoing referrals prior to scheduled visits. Follow up with practices that do not issue a referral or obtain referral on a timely basis
  • Interface with staff, providers, and patients regarding denied referrals. Document information and assist with alternate plan of care, if needed
  • Complete and maintain patient schedules. Schedule and coordinate patient visits and medical procedures for both inpatients and outpatients. Communicate with patients regarding all information related to scheduled appointments
  • Notify providers, patients and others of changes such as new scheduling, re-scheduling, no-show, emergency appointments and add-ons
  • Maintain recall lists and communicate with patients as appropriate. May inform nursing staff or others of laboratory and diagnostic study results; collect and mail 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 timesheets, expense vouchers, etc. Follow up with personnel outside the medical office to expedite timely action and alleviate, or report delays as appropriate
  • Provide guidance to departmental personnel in medical office on administrative policies and procedures
  • Comply with health and safety requirements and with regulatory agencies such as DPH, etc
  • Comply with established departmental policies, procedures, and objectives
  • Enhance professional growth and development through educational programs, seminars, etc
  • Attend a variety of meetings, conferences, and seminars as required or directed
  • Regular, reliable, and predictable attendance is required
  • Perform other similar and related duties as required or directed
Requirements
  • High School Diploma/GED (or higher)
  • 1+ years of customer service experience
  • 1+ years of experience working in a healthcare setting
  • Intermediate level of proficiency with Microsoft Office including Word, Outlook, Excel, etc
  • Ability to work in office at 5 Neponset St. Worcester, MA 01606
  • Ability to work 38.75 hours a week, Mondays through Friday from 8:30am-5pm
Preferred Qualifications
  • Specialized medical secretarial/medical office training
  • Previous pediatrics experience
Soft Skills
  • Ability to multitask and resolve patient concerns in a timely manner
  • Ability to think critically and exercise sound judgment
  • Excellent communication, interpersonal and organizational skills

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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