Engagement Center Rep I (Remote)

Major Responsibilities:
Uses protocols, facility/provider information, and established policies and procedures to seamlessly link the patient experience between the Engagement Center and the practice site.

Uses resources and critical thinking skills to assist inbound callers. Makes outbound calls when required or when follow up is deemed necessary.

Has the ability to recognize complex non-clinical problems and questions and escalates for resolution when needed.

Responsibilities include scheduling patient appointments and coordinating cancellations, reschedules, and additions to schedules. Obtains demographic and insurance information, verifies insurance coverage, and may collect co-pays, deductibles, and previous balances. Ensures insurance and patient information obtained is complete and accurate, updating information if necessary, applying acquired knowledge of government and third-party payer requirements. Updates financial responsibility and other data when changes or additions occur and communicates to patients as appropriate.

Provides referrals to physicians/providers. Completes all essential forms, obtains necessary information, such as patient demographic and insurance information. Verifies and updates the medical record with customer information.
Identifies emergent calls based on information provided by caller and department guidelines. Follows the process for immediate transfer to Registered Nurse for triaging or appropriate more experienced staff for resolution. Responsible for competency in and adherence to guidelines for emergency situations and critical call handling.

Determines the level of care needed by patients calling the call center which results in routing patients for triage, scheduling, rescheduling, and canceling appointments, submitting medication refill requests for evaluation, and paging providers and facilities as appropriate.

Provides customer service per established departmental standards as measured by patients on post call survey. Asks clarifying questions, presents options or solutions, and understands the level of complexity of the call, escalating only those situations necessary for resolution.

Assists with organizational marketing efforts by providing associated information and referral to customer, while maintaining appropriate records for documentation. Conducts regular reporting and updating of the provider and marketing databases.

Performs additional duties based on department needs such as faxing, updating medical records, logs, and reports, managing files/databases, assisting with entering, gathering, organizing, and compiling data for reports.

Maintains knowledge and efficient utilization of all information systems utilized by the department.

Licensure, Registration and/or Certification Required:
None Required.

Education Required:
High School Graduate.

Experience Required:
Typically requires 0 -1 year experience in a call center, healthcare or other applicable customer service-related area.

Knowledge, Skills & Abilities Required:
Knowledge of customer service and ability to work with a variety of patients and patient situations. Ability to follow workflows while operating in a structured environment

Basic knowledge of medical terminology is helpful, but not required.

Basic understanding of computers and desktop software packages.

Ability to work in a fast paced environment, handling a variety of customer/patient needs.

Basic multitasking and problem solving skills, as well as organization and prioritization skills.

Ability to use/manage a multiple-line telephone system.

Demonstrated ability for analysis, logical thinking, accuracy and concern for detail.

Strong verbal communication skills and ability to interact with a diverse customer population.

Ability to provide excellent customer service and follow up. Ability to converse with customers/patients while researching and documenting the call on multiple systems.

Ability to work with a variety of customers and actively listen to successfully determine the customer's needs. Ability to resolve customer issues.

Ability to work a variety of hours based on departmental business needs.

Physical Requirements and Working Conditions:
Must have functional vision, touch, speech, and hearing.

Required to sit most of the workday.

Operates all equipment necessary to perform the job.

Exposed to normal office environment and/or remote work environments

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.