Patient Service Representative

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities.

Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Reliant Pediatrics & Internal Medicine has an immediate opening for a friendly, patient focused and detailed oriented Patient Service Specialist to join our team. The Patient Service Specialist is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service, and adhere to Lean processes.

Supports the teams in meeting financial, clinical, and service goals.

Schedule (38.75 hours): Monday through Friday, between the hours of 8:30 am to 5:00 pm. The schedule will be determined by the practice manager upon hire.

Location: 24 Newton St. Southborough, MA

This individual would be expected to train onsite and work a hybrid‑remote model out of our Southborough, MA site with possibility of going 100% in the future. This position follows a hybrid schedule with in‑office days for initial training and as needed.

If you reside in Southborough, MA
, you will enjoy the flexibility of a hybrid‑remote role as you take on some tough challenges.

• Supports a high volume of calls typically for a defined region/dept with backup support to a sister region/dept adhering to department productivity standards set forth by service line.
• Screens all incoming patient inquiries (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 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 and answers any corresponding questions. Understands all documents and processes.
• Documents details of each call in the patient’s electronic medical record using both service line documentation tools as well as 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. 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 and communicates 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…