Patient Support Center Representative

OVERVIEW OF POSITION:Responsible for acting as a patient advocate to help resolve patient issues pertaining to claims, benefits referrals, physicians and access. Assists with patient education and ensures that required services are delivered to patients. Serves as a liaison between the patient and other departments and Optum sites. Assists other Patient Support Center Representatives and Supervisors with daily paperwork load as needed to resolve and/or document patient issues.ESSENTIAL FUNCTIONS:Consistently exhibits behavior and communication skills that demonstrate Optum’s commitment to superior customer service, including quality, care and concern with each and every internal and external customer.

Provides services to internal and external customers involving the exchange of complex and sensitive information while acting as patient advocate.

Assists other Patient Support Center Representatives and Supervisors with daily paperwork load as needed to resolve and/or document patient issues.

Exchanges complex and sensitive information with internal and external customers while acting as a patient advocate.

Recognizes financial, medical and legal risks based on data collected during customer interactions and follows appropriate procedures.

Answers customer calls to address inquiries and concerns within set productivity guidelines. Accesses Language Line for non-English patients as needed.

Resolves a wide variety of customer service issues.

Utilizes Optum systems to resolve customer needs such as appointments, authorizations, claims, invoices, eligibility, benefits, appeals, TARs.

Utilizes customer service module.

Utilizes resource center and relevant websites.

Translates oral information into concise and accurate written documentation per guidelines.

Assists new or potential members in the choice of PCP and supplies general information about medical group.

Pages clinicians and assists Telehealth Nurses as necessary (e.g., arranging DME, transportation and HH).

Data enters PCP changes into the system and processes paperwork as necessary.

Completes end-of-shift report and communicates information to the next shift operations.

Accesses language line for non-English patients as needed.

Understands the roles and responsibilities of Optum internal departments.

Manages own work queues within set productivity guidelines.

Demonstrates customer service-oriented behavior at all times.

Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

Performs additional duties as assigned.

EDUCATION:1 or 2 years of post-high school education or a degree from a two-year college.

EXPERIENCE:Minimum:Over 1 year and up to and including 3 years of experience.

Over 2 years of customer service experience.

Multi-line telephone experience.

Preferred:1 or more years of experience in a healthcare setting.

KNOWLEDGE, SKILLS, ABILITIES:Must pass Patient Support Center screening test.

Computer literate.

Proficient in Microsoft applications (Word, Excel).

Strong data entry skills.

Ability to type 35-40 wpm.

Ability to work in rotating shifts.

Customer service-oriented.

Excellent verbal and written English communication skills.

Ability to demonstrate active listening skills.

Excellent telephone skills and telephone etiquette.

Ability to handle difficult customer situations in a positive manner.

Ability to maintain composure in a challenging situation.

Excellent problem-solving skills.

Organized, detail-oriented and task-oriented.

Ability to multi-task and be flexible.

Self-motivated and team player.

Knowledge of medical terminology preferred.

Bilingual preferred (English/Spanish, English/Chinese, English/Korean, etc.)

If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work. (SM)Diversity creates a healthier atmosphere: Optum and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers 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. Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.