Patient Service Specialist - Pulmonary - Worcester, MA

Opportunities with Reliant Medical Group. When you join Reliant, you’ll be part of a community-based, multi-specialty, physician-led medical group. Everyone works collaboratively on a common purpose: improving the quality, cost and experience of health care. With the resources of a global health organization - Optum - behind us, we’re at the forefront of value-based care. Supported by a patient-centric business model - integrated care teams focus on the best patient care, rather than volume. Here, you’ll contribute to an exceptional patient experience. Discover a place where you can help shape the future of health care and do your life’s best work.(sm)

Coordinates the provision of multiple services to patients performing a full range of administrative support services for clinic/site including collection of co-payments, registration and scheduling of patients for medical procedures, tests, associated ancillary services and other related duties. Ensures the highest level of patient/customer satisfaction.    

Primary Responsibilities:

• Verifies, re-verifies and authorizes patient insurance coverage and eligibility utilizing computer-based patient registration/scheduling system.  Verifies and updates demographic, insurance, and other patient information.  Confirms, collects, and posts patient co-payments and other outstanding balances 
• Generates and tracks patient encounter forms.  Reviews patient encounter forms for completeness and resolves any discrepancies.  Batches encounter forms and submit to appropriate billing area
• Maintains records and makes daily cash deposit as assigned
• Receives and addresses patient-care related telephone calls.  Provides routine information on procedures and standard policies, refers matters to appropriate person within department/site
• Identifies problem related priorities, and responds to emergency needs by contacting/interrupting physician/provider within guidelines
• Resolves patients’ questions regarding clinic schedules and billing concerns; handles requests for prescription refills, reschedules appointments, etc.  
• Documents appropriate information in computer system. Prepares patient charts.  Ensures completeness by locating test results, reminding patients of appointments, including appropriate forms, etc., for patient appointments   
• Updates and maintains Telephone Message System (TMS) in computer system.  Follows through on requests.  Distributes messages to appropriate provider or others for appropriate action
• Enters new referrals or ensures that existing referral numbers are linked in the system to ensure managed care requirements
• Provides patient education regarding managed care plans and referral process. Answers patients’ referral questions, concerns, etc.  Provides patient with available options
• Works collaboratively with primary care practices, patients and specialty practices to process outgoing referrals prior to scheduled visits.  Follows up with practices that do not issue a referral or obtain referral on a timely basis.
• Interfaces with staff, providers and patients regarding denied referrals. Documents information and assists with alternate plan of care, if needed
• Completes and maintains patient schedules. Schedules and coordinates patient visits, medical procedures for both inpatients and outpatients. Communicates with patients regarding all information related to scheduled appointments.
• Notifies providers, patients and others of changes such as new scheduling, re-scheduling, no-show, emergency appointments and add-ons
• Maintains recall lists and communicates with patients as appropriate
• May inform nursing staff or others of laboratory and diagnostic study results; collects and mails test results
• May escort patient to examination rooms and chaperones patients as required
• May process standard and non-standard business office administrative paperwork, such as purchase requisitions, employee time sheets, expense vouchers, etc. Follows-up with personnel outside the medical office to expedite timely action and alleviate, or report delays as appropriate
• Provides guidance to departmental personnel in medical office on administrative policies and procedures
• Complies with health and safety requirements and with regulatory agencies such as DPH, etc. 
• 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

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
• Familiarity with various software applications such as Microsoft Word, Outlook, Excel, etc.
• Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:

• Additional specialized medical secretarial/medical office training
• Superior customer service skills including the ability to multi-task and resolve patient concerns in a timely manner
• Ability to think critically and exercise sound judgment
• Excellent communication, interpersonal and organizational skills

Unless certification, licensure or registration is required, an equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed in this description, may be substituted for the above requirements.

Physical Requirement:

• Physical health sufficient to meet the ergonomic standards and demands of the position

The Organization reserves the right to modify position responsibilities at any time, due to business necessity.

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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. 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. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Patient Service Specialist, Pulmonary, Worcester, MA, Massachusetts