Call Center Representative

Register and schedule patients' appointments by telephone utilizing the physician scheduler and individual departmental guidelines. Communicate with parents, patients, physicians, community doctors/staff and other staff in a courteous manner. Responsible for obtaining and validating patient information from various sources and to ensure information entered into the computer management system is accurate. Promote customer service environment.

Minimum Education

High School Diploma or GED (Required)

Minimum Work Experience

1 year Experience performing patient registration and scheduling, medical insurance screening and verification. (Required)

Functional Accountabilities

Registration and Scheduling Services

Provide client support to parent/guardian via phone for any or all of the following: on-line registration help; scheduling, rescheduling and/or canceling of appointments whether by parent/guardian or department; inform patient/parent of any departmental scheduling guidelines associated with appointment; reschedule all appointments related to clinic maintenance cancellation.

Notify parent of the need for completed insurance referral form or any pre-authorization of treatment prior to scheduled appointment; discuss co-payment or payment in full requirements; counsel or refer parent to central business operation's financial counseling or establish a payment plan.

Complete calls in an accurate and timely manner; transfer calls to appropriate areas as needed; notify manager/supervisor of difficult calls (clarification re insurance, problem callers, etc.); seek appropriate resources to solve problems effectively.

Anticipate customer service needs to "prevent fires."

Enter appropriate notes in the system; obtain necessary information for accurate and complete documentation of all registration printouts, consent documents and other forms.

Anticipate customer service needs to "prevent fires."

Verifying Insurance/Authorization and Process Improvement

Work with insurance companies to verify insurance eligibility and coverage for anticipated services using EVS, ENVOY, Mamsi-online, UHC and calling insurance; obtain authorization and benefit information from insurance companies as appropriate; document authorization and information in Account Notes and fields.

Collect and verify demographic, PCP/referring physician and insurance information.

Make recommendations for internal process improvements.

Safety

Speak up when team members appear to exhibit unsafe behavior or performance

Continuously validate and verify information needed for decision making or documentation

Stop in the face of uncertainty and takes time to resolve the situation

Demonstrate accurate, clear and timely verbal and written communication

Actively promote safety for patients, families, visitors and co-workers

Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance

Organizational Accountabilities

Organizational Accountabilities (Staff)

Organizational Commitment/Identification

Anticipate and responds to customer needs; follows up until needs are met

Teamwork/Communication

Demonstrate collaborative and respectful behavior

Partner with all team members to achieve goals

Receptive to others’ ideas and opinions

Performance Improvement/Problem-solving

Contribute to a positive work environment

Demonstrate flexibility and willingness to change

Identify opportunities to improve clinical and administrative processes

Make appropriate decisions, using sound judgment

Cost Management/Financial Responsibility

Use resources efficiently

Search for less costly ways of doing things

Safety

Speak up when team members appear to exhibit unsafe behavior or performance

Continuously validate and verify information needed for decision making or documentation

Stop in the face of uncertainty and takes time to resolve the situation

Demonstrate accurate, clear and timely verbal and written communication

Actively promote safety for patients, families, visitors and co-workers

Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance