Patient Services Representative II

UnitedHealth Group • Boston, MA

6d • $20 - $36 • Remote

About The Position

Under direct supervision, plays an expanded and advanced level role in the creation of superior access for patients. Duties include but are not limited to handling incoming patient inquiries and assisting patients in the management of appointments/care. Through a variety of support duties that facilitate the work of an interdisciplinary coordinated care delivery model, the Patient Service Representative plays an integral role in the support of our patients. As a level II representative, utilizes an advanced skill set to perform all duties of the Patient Service Representative I and serves as a resource and mentor for lower level representatives. Handles the more complex issues arising through incoming calls. Provides extraordinary customer service and strong problem-solving skills to strengthen the patient/clinician relationship. Must have clear verbal and written communication skills to ensure improved patient access.

Requirements

• High School Diploma/GED
• 2+ years of administrative experience in a medical setting
• Able to communicate in a professional and appropriate manner
• Strong interpersonal, customer service, time management, and organizational skills required
• Able to use all electronic tools and applications relevant to the performance of the duties of the position, including but not limited to phone, keyboard, computer and computer applications

Nice To Haves

• Previous EPIC experience preferred
• Strong problem solving and complex patient management skills preferred
• Working knowledge of patient related documents preferred

Responsibilities

• Maintains a higher degree of technical expertise than Patient Services Representative I and serves as role model to Patient Services Representative I’s.
• Able to problem-solve and serve as a resource to other Patient Services Representatives.
• Screens all incoming patient inquiries (through phone, online/medical record message, or other means) to determine whether those inquiries can be appropriately handled by the Patient Service Representative or if they need to be directed to other team members.
• Acts as a role model for other support staff and demonstrates a high level of competency in Patient Service Representative responsibilities.
• Proactively identifies issues and works to resolve them in areas involving patient satisfaction, patient flow, and compliance with procedures and guidelines. Advocates for patients as appropriate.
• Identifies and assists in resolving operational difficulties and communicates with supervisor regarding department issues and problems as necessary. Demonstrates a high level of competency when handling difficult phone calls and dealing with complex issues.
• Initiates request for forms, letters, medication renewals, referrals, prior authorizations, and any other administrative needs submitted by patients and answers any corresponding questions. Understands all documents and processes.
• Reviews and facilitates the updating of missing /outdated information in the patient record, such as demographics, primary care physician selection, and insurance.
• Develop and maintain effective and efficient communication with the patient, interdisciplinary team, department staff, providers, and other agencies.
• Reviews department appointment schedules to ensure that clinic utilization is optimized and effectively supports the needs of the clinics as well as the needs of the patients.
• Assists with data collection activities and provide appropriate follow up for statistical reports or required studies, ensuring data is properly collected and accurate (e.g. no show reports, telephone statistics).
• Receives escalated issues and determines appropriate action and/or works with clinical team for decision.
• Effectively deescalates issues with upset patients and practices. Uses advanced listening techniques to understand the issue and give patients options as they are available. Escalates to supervisors only as needed.
• Supports, mentors and trains lower level assistants.
• Participates in problem solving activities, focusing on productivity and quality. Works with supervisors to ensure continuous improvement of the department.
• Participates in special projects and ongoing programs unique to the department.
• May represent department on groups and teams related to upgrades of the electronic medical record.
• Performs functions of a Patient Service Representative I.
• Performs other duties as assigned.
• Accesses only the minimum necessary protected health information (PHI) for the performance of job duties.
• Actively protects the confidentiality and privacy of all protected health information they access in all its forms (written, verbal, and electronic, etc.) taking reasonable precautions to prohibit unauthorized access. Complies with all Atrius Health and departmental privacy policies, procedures and protocols. Follows HIPAA privacy guidelines without deviation when handling protected health information.
• Performs all job functions in compliance with applicable federal, state, local and company policies and procedures.
• Primarily remote with an occasional need to be present at a practice site for meetings or trainings.

Benefits

• 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.)
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED