Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The Patient Service Representative is responsible for supporting patient inquiries, ensuring excellent customer service, and adhering to established protocols to improve health outcomes.
Responsibilities
- Supports a high volume of calls typically for a defined region/dept with back up support to a sister region/dept 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- Reviews and facilitates the updating of missing /outdated information in the patient record with each call including demographics, primary care physician selection, and insurance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 and/or 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
Skills
- High School Diploma/GED (or higher)
- 1+ years of healthcare or customer service-related experience
- Intermediate level of proficiency with Computer-Based Navigation (ability to navigate multiple screens, document electronically, typing while speaking on the phone & familiarity with technology)
- Ability to work onsite as needed and work remotely from home
- 1+ years of experience working in a medical front office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays and maintaining medical records
- Proficiency in Microsoft Office (Word, Excel and Outlook)
- Knowledge of Epic EMR software
- Ability to learn new software (EPIC/EMR) and flexibility to attend new hire training
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.)
Company Overview
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group. It was founded in 2011, and is headquartered in Eden Prairie, Minnesota, USA, with a workforce of 10001+ employees. Its website is https://www.optum.com/.Company H1B Sponsorship
Optum has a track record of offering H1B sponsorships, with 506 in 2025, 559 in 2024, 620 in 2023, 851 in 2022, 593 in 2021, 438 in 2020. Please note that this does not guarantee sponsorship for this specific role.
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