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.

As a Healthcare Representative, you will interview and advocate for patients and their families to obtain maximum benefit coverage in a hospital or healthcare setting.

This position is full time, Tuesday – Saturday. Employees are required to have flexibility to work our normal business hours of 10:00 AM – 7:00 PM. It may be necessary, given the business need, to work occasional overtime. Our office is located at Mercy Medical Center, 271 Carew St., Springfield, MA, 01104.

We offer 4 – 6 weeks of paid on-the-job training. The hours of training will be 10:00 AM – 7:00 PM from Tuesday – Saturday.

Primary Responsibilities:

• Interview patients in a hospital setting and work effectively with hospital personnel to assist patients with obtaining maximum benefit coverage
• Complete applications for state and federal programs
• Review medical records and take all necessary actions to expedite benefit approval
• Adhere to company and legal standards regarding Protected Health Information (PHI), Personal Identifiable Information (PII), and Personnel Transaction Identifier (PTI)
• Maintain ongoing communication with government agencies regarding the status of claims
• Provide updates and assistance to hospital personnel and other Optum staff as needed
• Maintain documentation of status of claims and client contract on Optum and / or hospital computer systems
• Determine when to use a Federal, State or Local program application based upon medical definition of disability as it relates to body systems and to functions of daily living, and information contained in medical records
• Willing to work in a fast – paced hospital or healthcare environment

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 experience
• Must be 18 years of age OR older
• 1+ years of Customer Service experience
• Experience with Microsoft Office products
• Previous experience with working in a group OR office space setting
• Ability to work on site at Mercy Medical Center, 271 Carew St., Springfield, MA, 01104
• Ability to travel up to 10% of the time to local healthcare facilities
• Ability to work any shift between the hours of 10:00 AM – 7:00 PM from Tuesday – Saturday including the flexibility to work occasional overtime and weekends based on business need

Preferred Qualifications:

• 1+ years of Customer Service experience within a hospital OR healthcare environment
• Knowledge of federal and state programs that will benefit coverage for clients
• Knowledge of medical terminology
• Previous experience communicating with patients & staff with various educational & socio – economic backgrounds
• Bilingual fluency in English and Spanish
• EPIC experience

Soft Skills:

• Excellent organizational skills
• Strong communication skills

Physical and Work Environment:

• General office demands
• Prolonged periods of standing and walking in hospital facilities
• Adherence to facility masking requirements at all times