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 HealthCare Partners (HCP) sites. Assists other Patient Support Center Representatives and Supervisors with daily paperwork load as needed to resolve and/or document patient issues.
Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) 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 HCP 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 HCP internal departments.
Manages own work queues within set productivity guidelines.
Demonstrates customer service-oriented behavior at all times.
Uses, protects, and discloses HCP 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 two-year college.
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 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.)
What's the first thing that happens when one of the leading independent medical groups in the country comes together with a global leader in health care? Opportunity. With DaVita Medical Group, HealthCare Partners, The Everett Clinic, Northwest Physicians Network, MountainView Medical Group and Magan Medical Clinic joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. We're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.(SM)
Careers with OptumCare. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. OptumCare, 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: OptumCare 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. OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.