Patient Service Representative

Patient Service Representative at UnitedHealth Group

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Patient Service Representative

Requisition number 2335460 Job category Healthcare Delivery Primary location Worcester MA Additional locations Worcester Massachusetts Date posted 05042026 Overtime status Non-exempt Travel No

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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 inclusion talented peers comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

Join us to start Caring. Connecting. Growing together.

Reliant Pediatrics & Adult Medicine has an immediate opening for a friendly patient focused and detailed oriented Patient Service Specialist to join our team. The Patient Service Specialist is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial clinical and service goals.

Schedule 38.75 hours Monday through Friday between the hours of 830 am to 500pm. The schedule will be determined by the practice manager upon hire.

Location 5 Neponset Street Worcester MA

This individual would be expected to train onsite and work a hybrid-remote model out of our Worcester MA site with possibility of going 100 in the future. This position follows a hybrid schedule with in-office days for initial training and as needed.

If you reside in Worcester MA you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.

Primary Responsibilities

Supports a high volume of calls typically for a defined regiondept with back up support to a sister regiondept adhering to department productivity standards set forth by service line

Screens all incoming patient inquires through phone or potentially mychart 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. This includes chart review to identify previous activity that may have occurred related to the call

Adheres to service line booking guidelines to ensure that clinic utilization is optimized safely and effectively as well as supporting the needs of our patients

Initiates request for forms letters medication renewals referrals prior authorizations and any other administrative needs submitted by patients following standard work determined by service line and answers any corresponding questions. Understands all documents and processes

Documents detail each call in the patients electronic medical record using both service line documentation tools as well in addition to free text when appropriate to ensure coordination of care

Reviews and facilitates the updating of missing outdated information in the patient record with each call including demographics primary care physician selection and insurance

Effectively deescalates issues with upset patients and practices. Use advanced listening techniques to understand the issue and give patients options as they are available to help resolve and ensure satisfaction. May refer difficult or highly complex phone calls and issues to a supervisor

Participates in resolving operational difficulties and communicate with supervisor regarding department issues problems and opportunities for improvement

Develops and maintains effective and efficient communication with the patient interdisciplinary team department staff providers and other agencies

Participates in problem solving activities focusing on productivity and quality

Works with supervisors to ensure continuous improvement of the department

Attends required team andor regional meetings to learn new workflows and stay connected with teams working in a remote environment

Customer Service Ability to provide a high level of customer service to patients visitors staff and external customers in a professional service-oriented respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations

Decision Making Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance

Problem Solving Ability to address problems that are varied requiring analysis or interpretation of the situation using direct observation knowledge and skills based on general precedents

Written Communications Ability to summarize and communicate moderately complex information in varied written formats to internal and external customers

Oral Communications Ability to comprehend and communicate complex verbal information to medical center staff patients families and external customers

Knowledge Ability to demonstrate full working knowledge of standard work practices procedures and policies with the ability to use them in varied situations

Teamwork Ability to work collaboratively with interdisciplinary teams consisting of remote and onsite staff to improve the operations of immediate work groups by offering ideas identifying issues and respecting team members

Complies with health and safety requirements and with regulatory agencies

Complies with established departmental policies procedures and objectives

Enhances professional growth and development through educational programs seminars etc.

Attends a variety of meetings conferences and seminars as required or directed

Regular reliable and predictable attendance is required

Performs other similar and related duties as required or directed

What are the reasons to consider working for UnitedHealth Group

Put it all together - competitive base pay a full and comprehensive benefit program performance rewards and a management team who demonstrates their commitment to your success. Some of our offerings include

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 401k 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.

More information can be downloaded at httpuhg.hruhgbenefits

Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

High School