Call Center Representative

Job Description

Job Description

Call Center Representative

POSITION SUMMARY :

Responsible for scheduling patients for multi-specialty and primary care practices.

Responsible for obtaining a referring provider

Full Time – daylight hours with staggered shifts between 7 : 00am and 7 : 00pm

OVERVIEW :

Works under the supervision of the CRHPP Amin. The call center working supervisor performs detailed, accurate registration, eligibility verification and scheduling of all applicable patients to assure smooth workflow and productivity for staff and providers. Oversee the call center representatives and the call center itself. Order any needed supplies. Answers and routes phone calls appropriately and confirms patient appointments. Maintains the integrity of the demographic information of the patient, insured, guarantor and insurance company. Displays professionalism and high-quality customer service during all patient encounters. Performs other duties as assigned.

QUALIFICATIONS :

A. Knowledge, Skills and Abilities

Excellent customer service skills.

Reads and understands the English language.

Ability to think critically and analytically with little or no supervision.

Ability to work effectively in situations of high stress and conflict and communicate goals and outcomes.

Ability to process information and prioritize.

Possesses exceptional verbal and written communication skills.

Possesses independent work habits, is self-reliant and self-directed.

Ability to learn, adapt and change as required by the job functions.

Ability to maintain absolute confidentiality of material and information accessed and reviewed.

Basic computer literacy.

Ability to maintain attendance to meet standard job practices.

B. Education

High School Graduate or GED required.

C. Licensure

N / A

D. Experience

Computer and typing skills

Business training preferred but not required.

Knowledge of medical terminology is helpful.

E. Interpersonal skills

F. Essential technical / motor skills

G. Essential physical requirements

Sedentary : exert up to 10lbs of force occasionally

H. Essential Mental requirements

I. Essential sensory requirements.

J. Other :

Basic understanding of Medicaid, Medicare and Commercial Insurance guidelines.

Analytical and organizational skills must be above average

Attention to detail, communication, and documentation skills must be excellent.

Prior customer service experience is required

Operations of computer systems and business machinery also required.

Must have the ability to communicate with patients in a courteous manner and possess excellent telephone communication skills with the ability to remain calm in difficult situations.

Must have the ability to talk with the public in a professional manner.

Must have excellent interpersonal communication skills and possess a professional and neat appearance.

K. Equipment used

OTHER QUALIFICATIONS

A. Exposure to hazards (Body fluid exposure level)

Level I

B. Age of patient populations served

Children – 0 – 12 years

Adolescents- 13-18 years

Adults – 19-70 years

Geriatrics – 70 years

JOB SPECIFIC DUTIES AND PERFORMANCE STANDARDS

Below are tasks, duties and responsibilities that comprise the means of accomplishing the position’s purpose and objectives. These are critical or fundamental to the performance of the position. They are the major functions for which the person in the position is held accountable. The following are the essential functions of the position, along with the corresponding performance standards.

Major Task, Duties and Responsibilities

• Be committed to the Standards of Performance, CRMC’s and Financial Counseling Mission and Vision statements.
• Responsible and accountable for tasks necessary to properly identify patient, create an accountable for the patient, with accurate insurance information. Maintain an acceptable accuracy rate.
• Responsible for scheduling patients by telephone and entering patient demographics accurately.
• Responsible for scheduling and rescheduling patient appointments across multi-specialty offices.
• Handle 100-200 calls incoming daily.
• Responsible for learning scheduling criteria for each office / provider.
• Answering telephone professionally, courteously and maintains a high degree of patient confidentiality. Answer all inquiries in a courteous and timely manner. Use the scripting policies as a guide to effective communication with customers.
• Continue to stay informed of any policy or regulation changes that could affect collection or receivables. Updating personnel manual with current revisions of policies and attend all staff meetings and in-services as required.
• Refer uninsured patients to the Practice Manager for counseling prior to scheduling.
• Comply with all established CRHPP and CRMC policies and procedures to include but not limited to attendance, dress code and safety.
• Understands the significance of the organization’s Performance Improvement Programs and is an active participant.
• Provide excellent customer service to all patients and family members and promote a positive image of CRMC and CRHPP. Communicate the mission, ethics and goals of CRMC / CRHPP.
• Ask appropriate questions and get patients to correct nurse or medical staff member.
• Maintain a high degree of patient confidentiality in accordance with HIPAA regulations.
• Responsible for all other functions as required and directed by supervisor.
• Check phone messages every 15 to 20 minutes.
• Ability to produce workable ideas and techniques, willingness to attempt new approaches and perform job duties independently.
• Perform duties in an independent manner with minimal direct supervision.
• Can solve day-to-day problems within scope of practice and make decisions in a timely manner.
• Offers workable ideas, concepts and techniques to improve productivity.
• Willing to attempt new job duties, tasks, etc.
• Maintains regulatory requirements including all state, federal regulations relating to Patient Access and, as appropriate, to the organization.
• Check inboxes regularly throughout the shift for referrals and appointment requests.