Patient Service Representative

UnitedHealth Group•Worcester, MA

13d•$16 - $29•Hybrid

About The Position

Optum is seeking a friendly, patient-focused, detail-oriented Patient Service Representative for Reliant Pediatrics & Adult Medicine. The role completes established processes and protocols, works cooperatively with the care team, delivers excellent customer service, adheres to Lean processes, and supports financial, clinical, and service goals. The representative supports a high volume of patient calls and inquiries, screens requests and routes them appropriately, follows booking guidelines, and initiates administrative requests such as forms, letters, medication renewals, referrals, and prior authorizations. The role documents calls in patients’ electronic medical records, updates patient information, helps resolve concerns, and coordinates with patients, care teams, staff, providers, and external agencies. It also contributes to operational problem solving and continuous improvement, attends team meetings, and follows departmental policies and health and safety requirements. The position is based at the Worcester, Massachusetts site and follows a hybrid-remote model, with onsite training for approximately the first six weeks and additional in-office attendance as needed. The stated schedule is 38.75 hours per week, Monday through Friday, between 8:30 a.m. and 5:00 p.m.; the practice manager determines the specific schedule. There may be a possibility of moving to a fully remote arrangement in the future.

Requirements

High school diploma or GED.
At least 1 year of experience working in an office setting; medical-office experience is preferred, including answering a high volume of phone calls and working with EPIC or a similar electronic medical record system.
Intermediate proficiency in Microsoft Word, Excel, and Outlook.
Ability to work onsite for approximately the first six weeks of training.
Ability to provide professional, respectful customer service and remain calm in stressful situations.
Ability to make decisions using general instructions and practices, and to recommend solutions to problems of moderate complexity.
Ability to analyze varied problems using observation, knowledge, skills, and general precedents.
Ability to summarize and communicate moderately complex information in writing and comprehend and communicate complex verbal information.
Working knowledge of standard work, practices, procedures, and policies, and ability to apply them in varied situations.
Ability to work collaboratively with remote and onsite interdisciplinary teams.
Ability to work independently with good judgment and accountability.
Ability to prioritize tasks and meet deadlines.
Ability to work effectively in a remote environment and under pressure in a fast-paced setting.
Strong organizational, time-management, verbal communication, and written communication skills.
Regular, reliable, and predictable attendance.
Ability to pass a drug test before beginning employment.
Adherence to UnitedHealth Group’s Telecommuter Policy for telecommuters.

Nice To Haves

Proficiency in Microsoft Teams in a remote setting.
Experience in a medical setting, including answering a high volume of phone calls and using EPIC or a similar electronic medical record system.

Responsibilities

Support a high volume of calls for a defined region or department, with backup support for a sister region or department, while meeting service-line productivity standards.
Screen incoming patient inquiries by phone or potentially MyChart, review relevant chart activity, and determine whether to handle or route each inquiry.
Follow service-line booking guidelines to support safe and effective clinic utilization and patient needs.
Initiate and respond to requests for forms, letters, medication renewals, referrals, prior authorizations, and other administrative needs according to standard work.
Document calls in the patient’s electronic medical record using service-line tools and free text when appropriate to support care coordination.
Review and facilitate updates to missing or outdated patient information, including demographics, primary care physician selection, and insurance.
Deescalate concerns from upset patients and practices using active listening and available resolution options; refer difficult or highly complex issues to a supervisor when appropriate.
Help resolve operational difficulties and communicate department issues, problems, and improvement opportunities to a supervisor.
Maintain effective communication with patients, interdisciplinary teams, department staff, providers, and other agencies.
Participate in problem-solving and continuous-improvement activities focused on productivity and quality.
Attend required team or regional meetings to learn workflows and stay connected with remote teams.
Comply with health and safety requirements, regulatory requirements, departmental policies, procedures, and objectives.
Pursue professional development through educational programs, seminars, and required meetings or conferences.
Maintain regular, reliable, and predictable attendance and perform other similar duties as required or directed.

Benefits

Paid time off accruing from the first pay period and 8 paid holidays.
Medical plan options and participation in a Health Spending Account or Health Savings Account.
Dental, vision, life and accidental death and dismemberment insurance.
Short-term 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, including pet insurance, legal insurance, and long-term care insurance.
Performance rewards and incentive and recognition programs.
Comprehensive benefits package.