Call Center Representative

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Position Title: Call Center Representative

ADA: Full time position. Ability to sit for long periods of time and/or stand periodically during work day and lift up to 30 lbs., when necessary. Computer data entry a portion of job duty.

OSHA: Must adhere to universal precautions, to include blood borne pathogen protection, at all times

Position Summary: The Call Center Representative serves as the primary contact for patients and other customers attempting to schedule an appointment, reach their provider, or ask general questions involving CHC. The Call Center Representative is responsible for providing first class customer service and ensures that all necessary data is completed properly, accurately and thoroughly. In addition, communicates to the patient pertinent information with regard to any financial balances and/or any instructions prior to and upon arrival of scheduled appointments. The Call Center Representative provides customer satisfaction to both internal and external customers and strives to continuously improve service delivery.

Role and Responsibilities:

• Employee has a working knowledge of and is able to explain all aspects of the Medical Records Policies and Procedures. (i.e. medical record request process )
• Responsible party and patient demographics including address verification are completely entered into the system in accordance with the policy and procedure manual to include name, date of birth, social security number, income, family size, alerts, extended member data, etc. Patient status in the EHR is updated timely
• Employee accurately explains patient responsibility for all payor codes. (i.e., insurance, sliding fee scale, Medicaid, Medicare, and special programs).
• Retrieves messages from phone voice mail in a timely manner (and responds to patient needs according to medical priority). Documents all incoming calls on paper phone log and transfers information to the electronic telephone template prior to “tasking providers” and clinical support staff.
• Responds appropriately within skill level and documented departmental policies and when appropriate, seeks provider advice when responding to patient’s medical care
• Follows through in a timely manner on patient requests
• Answer the telephone in a courteous and professional manner
• Provide “warm” transfers (ensure transferred call recipient is notified of caller’s name, reason for call, etc.) for external and internal callers, when not forwarding to a queue
• Schedule patient appointments according to FCHC protocols
• Take accurate, detailed messages from patients for providers and other office staff
• Ensure patient’s demographics and insurance information is verified and corrected as required
• Inform patient (at time of scheduling) of their responsibilities (i.e. coming on time, bringing insurance card, fasting if appropriate, etc.)
• Perform outbound calls in an attempt to contact the patient in order to confirm the scheduled appointment
• Maintain proper and accurate documentations of all activities.
• Maintain minimum monthly performance expectations such as: Average Calls Answered, Average Talk Time, Patient Satisfaction scores; and any other phone metric requirements
• Maintain patient confidentiality at all times in accordance with HIPPA regulations
• Perform other duties as assigned
• Employee has a working knowledge of and is able to explain all aspects of the Medical Records Policies and Procedures. (i.e., terminal digit, medical record pulling/filing, medical record organization, purging inactive charts, report filing, release of records, subpoenas etc.)
• Greets patients as they arrive, has patient sign in and verifies their status (appointment). Maintains a warm and friendly environment and exhibits good customer service
• Properly performs appointment processing to include pulling and preparing medical records the day before scheduled appointment, and utilizes the automated appointment system according to center policy following provider templates
• Responsible party and patient demographics including address verification are completely entered into the system in accordance with the policy and procedure manual to include name, date of birth, social security number, income, family size, alerts, extended member data, etc. Patient status in the Catalyst system is updated timely.
• Properly identify and verify third‐party coverage, sliding fee scale eligibility and complete appropriate forms (i.e., insurance verification form, Availity, Medicare questionnaire [MSP], Medicaid verifications, etc.). Obtain proof of income annually with tax return or three consecutive pay stubs. Ensure proper pay codes are added to account including selecting proper carriers and ID numbers as required for accurate billing.
• Understand definition of and determines migrant seasonal farm worker status, homeless status, and properly enters into the system
• Employee accurately explains patient responsibility for all payor codes. (i.e., insurance, sliding fee scale, Medicaid, Medicare, and special programs).
• A properly executed consent for treatment is obtained according to policy

Qualifications and Education Requirements:

Minimum Requirements (experience, training, and education): To effectively fulfill this position, candidate must meet the following requirements:

• High School Graduate or Equivalent
• One (1) year of Data Entry/Medical Office Experience
• Strong Customer Relations Skills

This job description is not intended to be all-inclusive, and the employee will also perform other reasonable related business duties as assigned by supervisor.

• This organization reserves the right to revise or change job duties and responsibilities as the need arises. This job description does not constitute a written or implied contract of employment.