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
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
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
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
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
Manages own work queues within set productivity guidelines.
Demonstrates customer service-oriented behavior at all
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.
1 or 2 years of post-high school education or a degree from a
Over 1 year and up to and including 3 years of experience.
Over 2 years of customer service experience.
Multi-line telephone experience.
1 or more years of experience in a healthcare setting.
KNOWLEDGE, SKILLS, ABILITIES:
Must pass Patient Support Center screening test.
Proficient in Microsoft applications (Word, Excel).
Strong data entry skills.
Ability to type 35-40 wpm.
Ability to work in rotating shifts.
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
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,
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.