Job Description

Who are we? Optum360. We're a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage our compassion, our talent, our resources and experience to bring financial clarity and a full suite of Revenue Management services to Healthcare Providers, nationwide.

If you're looking for a better place to use your passion, your ideas and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.

Healthcare isn't just changing. It's growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that's what fueled these exciting new opportunities.

The Patient Service Representative is responsible for coordinating and maintaining a positive customer experience while performing pre - registration, registration, scheduling, and business office functions. Must possess excellent customer service skills. Be able to interact in a friendly, professional manner with a wide range of patients, operations staff, physicians, and other departments within the Excela Health system. Attention to detail and the ability to work well under pressure is essential. Also must be able to function effectively in an environment where it is necessary to perform several tasks simultaneously, and where interruptions are frequent.

This position requires a Pre - Employment Health Screening upon acceptance of any offer. Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease.

This is a per-diem position (18+ hours/week). Employees are required to have flexibility to work any of our shift schedules and must be available to work Monday - Sunday between 8:00am - 8:00pm EST.

Primary Responsibilities:

* Regular, consistent, on - site, and timely attendance
* Schedules patient appointments for designated departments
* Schedules appointments utilizing scheduling software tools
* Provides testing instructions to assure smooth services
* Secures authorization and referral if applicable
* Customer Focus. Assesses customers' needs and considers customer in all decision-making processes to ensure a positive customer experience
* Greets the customer in a polite and professional manner whether face - to - face or on the phone, determines needs and responds appropriately and courteously
* Responds to customer issues (intra - departmental, inter - departmental, and public) timely and to the satisfaction of the customer
* Identifies and performs appropriate action in situations where it is necessary to obtain appropriate documentation for proper advancement through the revenue cycle
* Communication. Provides constructive feedback and clearly expresses ideas
* Interviews patients and / or their representatives in order to obtain accurate demographic, insurance, and claim adjudication information in a timely, courteous, professional manner
* Updates system appropriately and accurately, ensuring appropriate signatures are obtained and required authorizations / certifications / medical necessity guidelines are met
* Communicates with management all issues that impact the accurate, timely and complete accomplishment of all assigned tasks
* Identifies and communicates to management recommendations for process improvement
* Displays dignity and respect in all interactions
* Initiative. Readily accepts and incorporates changes into daily activities
* Conforms consistently to all system changes; including insurance payer regulations
* Possess functional knowledge of systems and the revenue cycle in order to adequately assist customers and reduce the unnecessary transfer of work flows
* Follows all department processes and policies as required and updated
* Motivation and Influencing. Influences and persuades others to build commitment to quality and a positive hospital experience
* Acts as a role model for peers by striving for excellence, displaying a positive attitude, and actively supporting the team concept
* Monitors and reports on individual productivity to assist in the evaluation of one's ability to organize and plan daily work in order to meet outcome - based criteria set by management
* Volunteers to work additional hours or offers to contribute to on - going projects / assignments outside the scope of their own specific functions
* Fiscal Accountability. Holds self - accountable for departmental processes in order to obtain maximum reimbursement for services and the successful flow of the revenue cycle
* Assures proper identification of patients presenting for services following the proper departmental procedures
* Maintains accuracy of insurance coverage and guidelines including not but limited to verifying coverage through online eligibility software/insurance web - sites / customer service phone lines; completing Medicare Secondary Questionnaire when required; verifying medical necessity and ABN processes; determining if necessary authorizations or referrals have been obtained; ensuring each order meets current published standards; etc
* Investigates and identifies patient - responsibility dollar amounts in order to successfully collect point-of-service payments when appropriate
* Charges posting where applicable when staff is not available timely

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 higher)
* Ability to work a maximum 18 hours per week Monday- Sunday between 8am-8pm EST
* 1+ years of customer service experience
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

* 1+ years of admissions, scheduling, or business office experience
* Knowledge of Medical Terminology
* Proficient Keyboard Skills measured at 30+ wpm
* Basic working knowledge of computers and office equipment
* Basic Math and Keyboard Proficiency
* Knowledge of Payor / Insurance Benefits

Soft Skills:

* Excellent communication, interpersonal and organizational skills
* Ability to communicate with all members of the health care team
* Proficient oral and written communication skills
* Ability to multi - task and prioritize assignments

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

Careers with Optum360. At Optum360, we're on the forefront of health care innovation. With health care costs and compliance pressures increasing every day, our employees are committed to making the financial side more efficient, transferable and sustainable for everyone. We're part of the Optum and UnitedHealth Group family of companies, making us part of a global effort to improve lives through better health care. In other words, it's a great time to be part of the Optum360 team. Take a closer look now and discover why a career here could be the start to doing your life's best work.

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.

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