Patient Service Representative

Under direct supervision, assists patients through management of incoming calls related to various appointment and medical care needs. The Patient Service Representative plays an integral role as a member of the patients care team by screening all incoming calls and helping complete the request with first call resolution or directing to another member of the interdisciplinary care team. Provides extraordinary customer service and strong problem-solving skills to strengthen the patient/ care team relationship. Manges a high volume of calls most often from a remote setting for a defined service line and is responsible to organize and prioritizes action items following standard work, including allocating tasks to the appropriate member of the care team, and ensuring efforts are coordinated and avoid duplication. Must have clear verbal and written communication skills to ensure the patient and team members understand next steps.

This position is full time, Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:30am – 5:00pm. It may be necessary, given the business need, to work occasional overtime.

We offer 4-6 weeks of on-the-job training. The hours of training will be aligned with your schedule.

 Primary Responsibilities:

• Supports a high volume of calls typically for a defined region/department with back up support to a sister region/department 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 guideline ensuring safe and optimized clinic utilization that supports 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 including answers any corresponding questions. Understands all documents and processes.
• Documents details of each call in the patients’ electronic medical record using both service line documentation tools as well as 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. Uses 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, communicating with supervisors 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.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction 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 Diploma/GED OR equivalent customer service experience in a clinical setting
• Must be 18 years of age OR older
• 1+ years of customer service experience in a clinical setting 
• Electronic Medical Record (EMR) experience 
• Ability to work fulltime, Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:30am – 5:00pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Experience in an Automatic Call Distribution (ACD) call center setting
• EPIC experience

Telecommuting Requirements: 

• Reside within commutable distance to the office at WORCESTER-100 FRONT STREET
• Ability to keep all company sensitive documents secure (if applicable) 
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy. 
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.