Representative,PCC Clinical Services 3

Summary

Bilingual Spanish Speaking Preferred

Schedule: Monday-Friday: 7:30am - 4:30pm

PRIMARY FUNCTION

Answer incoming calls from our patients and can triage high acuity patients to provide outstanding customer service in support of our mission, goals, and values.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This list may not include all the duties that may be assigned.

1. Answer incoming calls by welcoming patients with a professional, upbeat, friendly attitude.
2. Follow prepared scripts based on call type.
3. Register new patients by gathering pertinent information and entering XPM system.
4. Verify insurance coverage and information.
5. Set patient appointments upon request and identify future visits.
6. Document accurately and efficiently within all systems (XPM, CRM, EHR).
7. Document all questions and messages for Clinicians and label them properly using our telephone communication access protocol.
8. Data entry and maintenance of customer databases.
9. Properly obtain and confirm patients/caller information abiding by HIPPA law.
10. Collect all necessary and pertinent information over the phone to facilitate timely and accurate physician follow-up.
11. Complete any necessary referrals requested by telephone contact for provider approval.
12. Provide customers with product and service information.
13. Respond to patient inquiries.
14. Research required information using available resources.
15. Communicate with offices when necessary.
16. Handle customer complaints and other customer support related issues and provide customers with proper solutions.
17. Meet established standards within all performance criteria.
18. Attend any necessary training/meetings to be up to date on protocol changes and available training.
19. Other duties may include, but are not limited to, outbound calls, copying, faxing, etc.

Below are additional functions of the job for Patient Contact Center Representatives that will perform as clinical agents: (This list may not include all the duties that may be assigned.)

1. Provide medical guidance via telephone using our telephone communication access protocol, clinical triage algorithms, and clinical judgment.
2. Document all medical advice given over the phone.
3. Schedule appointments using clinical prioritizing protocols and our scheduling policies.
4. Answer calls and questions from Patient Contact Center Representatives and can triage high acuity patients.

QUALIFICATIONS

EDUCATION:

• High School diploma or equivalent.

EXPERIENCE:

• Prefer minimum of one year experience in a call center environment.
• Knowledge of XPM and CRM system desired.
• Familiar with automated call distribution, IVR, and skill-based routing systems.
• Previous customer service experience required.  

LICENSURE / CERTIFICATION

• Representatives that are performing as Clinical Agents require at least one of the following licensures or certificates.
• Registered Nurse license required.

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge of XPM/EHR and Contact Recorder desired.
• Familiar with automated call distribution, IVR, and skill-based routing systems.
• Must have strong verbal, written, and interpersonal communication skills.
• Experience with coaching and mentoring employees.
• Demonstrates ability to work well in a team environment.
• Strong multi-tasking skills.
• Attention to detail, accuracy and timeliness are critical.
• General PC knowledge including Microsoft Office, Internet, and Email.
• Needs to be proficient in Power Point.