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Optum

Patient Care Coordinator

Posted Yesterday
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In-Office
Southborough, MA
18-32 Hourly
Junior
In-Office
Southborough, MA
18-32 Hourly
Junior
Coordinates patient access and administrative care activities, including insurance verification, scheduling, check-out, referrals, prior authorizations, billing questions, prescription refill requests, and documentation in Epic. Handles patient calls, chart reviews, appointment lists, mail, and faxes while escalating urgent concerns appropriately. Supports departmental compliance, participates in meetings and training, and helps educate new patient service staff.
The summary above was generated by AI
Requisition Number: 2383743
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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together.
Location: 24 Newton St. Southborough MA
Schedule: Monday - Friday 7:15am - 4pm
Primary Responsibilities:
  • Verifies and authorizes patient insurance coverage and eligibility. Updates demographics and other patient information including necessary consents and other documents
  • Maintains collection records and makes daily cash deposits as assigned
  • Schedules patients accurately, according to department protocols and provider preference
  • Completes patient check-out, coordinates scheduling, and other services as directed. Manages and updates the department appointment report
  • Provides education, estimate preparation, and other pre-appointment instruction as needed
  • Receives and addresses patient-care-related telephone calls. Provides routine information on procedures and standard policies, and refers matters to the appropriate person within the department/site
  • Resolves patient's questions regarding clinic schedules and billing concerns; handles requests for prescription refills, reschedules appointments, etc.
  • Accurately and appropriately documents information in the electronic medical record system
  • Receives and processes incoming and outgoing insurance referral requests based on department protocol. Collaborates with staff, patients, and providers as needed to complete requests. Completes follow-up and documentation as needed
  • Obtains prior authorizations for various orders (such as sleep studies, cardiac imaging, outside imaging) according to established procedures
  • Performs appropriate action regarding, No Show, Cancellations, Recall, Waitlist and Reschedule lists, per established guidelines. Follows up with the patient, provider, etc. as needed
  • Processes personal in-basket and department pool encounter in Epic in a timely and appropriate manner
  • In conjunction with department leadership and training acts as an educator to new PSS staff
  • Processes department and provider mail and faxes in a timely and appropriate manner
  • Performs chart review in order to satisfy patient requests for form completion, resolve patient complaints or inquiries, or coordinate care related to appointment scheduling
  • Able to identify when patient-related issues need urgent attention and escalate to nursing or provider and/or leadership as needed
  • Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
  • Complies with established departmental policies, procedures, and objectives
  • Participates in learning opportunities provided through the learning management system
  • Participates in departmental meetings and huddles as directed by department leadership
  • 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 directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • 1+ years of customer service experience

Preferred Qualifications:
  • 1+ years of experience do you have providing administrative support in a healthcare, medical office and/or health insurance environment

Skills:
  • Ability to think critically and exercise sound judgment and manage multiple priorities and deadlines
  • Excellent communication, customer service, interpersonal and organizational skills

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #RED

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