Healthcare Representative
About The Position
The Healthcare Representative works onsite at Columbia Memorial Hospital in Hudson, New York, interviewing patients and working with hospital personnel to help patients obtain the maximum benefit coverage available. The role completes applications for state and federal programs, reviews medical records, and takes necessary steps to expedite benefit approval. It determines which Federal, State, or Local program application to use based on medical definitions of disability, daily living functions, and information in medical records. The representative communicates with government agencies about claim status and provides updates and assistance to hospital personnel and other Optum staff. The role maintains claim and client-contract documentation in Optum and/or hospital computer systems and follows company and legal standards for protecting PHI, PII, and PTI. This is a full-time, onsite role with on-the-job training. The regular schedule is Monday through Friday, with flexibility to work shifts during normal business hours of 8:00 AM to 4:30 PM; occasional overtime may be necessary. Local travel to healthcare facilities may be required, up to 10%.
Requirements
- High school diploma/GED or equivalent experience.
- Must be at least 18 years old.
- At least 1 year of customer service experience.
- Experience with Microsoft Office products.
- Experience working in a group or office-space setting.
- Ability to travel up to 10% to local healthcare facilities.
- Ability to work onsite at Columbia Memorial Hospital, 71 Prospect Ave, Hudson, NY 12534.
- Ability to work Monday through Friday from 8:00 AM to 4:30 PM, with occasional overtime if business needs require it.
- Excellent organizational skills.
- Strong communication skills.
Nice To Haves
- At least 1 year of customer service experience in a hospital or healthcare environment.
- Experience communicating with patients and staff from various educational and socioeconomic backgrounds.
- EPIC experience.
- Bilingual fluency in English and Spanish.
- Knowledge of medical terminology.
- Knowledge of federal and state programs that provide benefit coverage for clients.
Responsibilities
- Interview patients in a hospital setting and work effectively with hospital personnel to help patients obtain maximum benefit coverage.
- Complete applications for state and federal programs.
- Review medical records and take necessary actions to expedite benefit approval.
- Adhere to company and legal standards regarding Protected Health Information (PHI), Personal Identifiable Information (PII), and Personnel Transaction Identifier (PTI).
- Maintain ongoing communication with government agencies regarding claim status.
- Provide updates and assistance to hospital personnel and other Optum staff as needed.
- Maintain documentation of claim and client-contract status on Optum and/or hospital computer systems.
- Determine whether to use a Federal, State, or Local program application based on medical definitions of disability, functions of daily living, and medical-record information.
- Work effectively in a fast-paced hospital or healthcare environment.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs, subject to eligibility requirements.
- Equity stock purchase, subject to eligibility requirements.
- 401(k) contribution, subject to eligibility requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
