Client Service Specialist - Community Site

Overview

The Client Service Specialist (CSS) position routinely independently performs multiple administrative functions within a

interdisciplinary, community-based, stationary and/or mobile ambulatory practice. This position supports medical, behavioral health and dental providers, nurses, social workers and administrators and is able to move effortlessly across various teams and/or locations. This role coaches and mentors Client Service representatives (CSRs) and exemplifies excellent first line customer service.

Key Role Responsibilities

• Performs and fulfills all of the duties and responsibilities of the CSR position (registration, scheduling, insurance verification, referrals, and medical records) as a routine part of their daily duties.
• Processes referrals generated by providers at discharge, which includes: identifying referral entity, obtaining authorizations if needed, completing all necessary paperwork, and faxes supporting documents to the referring entity; Follow-up with clients and or the referring entity regarding outstanding referral issues as needed; Assist clients with scheduling referral appointments as needed; Track and report processing issues to supervisor; Verify client insurance benefits to obtain pre-authorization
• Process and maintain priority release of information and daily scanning of incoming records in adherence to the agency’s Medical Records Procedure; manages the workflow of medical records to maintain efficiency and high accuracy in release of records and receipt of records from outside providers
• In collaboration with the Practice Manager, documents and maintains customer service actions and helps identify client satisfaction improvement strategies.
• Responds promptly and appropriately to client questions/concerns/complaints and attempts immediate resolution; Identifies client needs and connects with other services, (e.g. case management and CHW) within the agency or through established external partners.
• Support Practice manager with compiling and coordinating data for analysis and assessment of clinic flow, fiscal expenditures, and service delivery
• Provide customer service excellence marked by culturally-competent, client-centered, ethical, respectful, inclusive, and professional access for clients, visitors, partners and the broader community.
• Contributes to the achievement of established department goals and objectives. Adheres to department policies, procedures, quality standards and safety standards. Complies with rules, regulations, policies, and procedures of all applicable agency, local, state, federal and regulatory bodies.

Key Agency Responsibilities

In addition to role responsibilities, each staff member of Health Care for the Homeless has the following responsibilities as a part of their employment:

• Models and reinforces the Health Care for the Homeless core values of dignity, authenticity, hope, justice, passion and balance
• Actively participates in performance improvement and advocacy activities that support the mission
• Performs other duties on an as-needed basis
• Protects clients’ personal health information by maintaining compliance with HIPAA and other relevant Health Care related IT security regulations

Knowledge, Experience and Skills

Formal Education and Training

• High school diploma or GED is required; Associate’s degree or higher level education preferred; relevant work experience may be substituted for formal education credit hours.
• Course completion with accredited program in community health, health education, health care or public health administration, human services, medical practice management systems, or related field is highly desirable.
• Completion of Certified Application Counselor (CAC) preferred

Experience

• Minimum of one (1) year experience fulfilling all duties and responsibilities of a Client Service Representative or similar role in a FQHC, ambulatory care, or hospital setting.
• Two (2) or more years of experience in health or human services; Bachelor’s degree in public health, human services, or related administration field may substitute for experience.
• Two (2) or more years of customer services experience.
• Understanding of ambulatory practice management, physician office and/or clinical operations.
• Practice working collaboratively in a multi-disciplinary clinical setting
• Experienced operating general office machines such as computers, facsimiles, copiers, and scanners
• Demonstrated knowledge of database programs; such as: Microsoft Office, FaxCom, and EHR systems.
• Familiarity with medical, administrative, ethical and the legal requirements of HIPAA and ADA;
• Understanding of third party insurance and accountable/managed care concepts

Skills

• Ability to communicate effectively in English, both verbally and in written form
• Effectively and efficiently work independently with minimum supervision; self-manage to organize and prioritize work to multi-task and meet deadlines
• Ability to work collaboratively across interdisciplinary teams; Capable of coordinating multiple workloads
• Ability to follow complex instructions and procedures, with a close attention to detail
• Able to exercise sound judgment and critical thinking in the execution of job duties
• Ability to identify, assess, and communicate needs and challenges
• Comfortable training others as well as breaking down and delegating tasks, when appropriate
• Adept at providing highly proficient customer service
• Ability to be flexible and responsive to ever-changing agency needs and act accordingly
• Able to work with physically, mentally, socially, and economically disadvantaged individuals
• Ability to work with clients from diverse backgrounds and/or with limited language proficiencies.
• Familiarity with de-escalation techniques during stressful, inflammatory, or hostile circumstances