Call Specialist, Primary Care Internal Medicine

Located in Largo in the heart of Prince George’s County, our new state-of-the-art regional medical center (UM Capital Region Medical Center) will provide improved access to primary and ambulatory care services and serve as a tertiary care center for critically ill patients. In addition, our new space will allow us to expand our offerings as a community partner to help improve the health status of Prince George’s County residents.

POSITION SUMMARY

Under the regular supervision of the Communication Center Supervisor and Business Operation Manager, the Call Specialist prepares and manages documentation involving the registration and scheduling of patient’ appointments by telephone in compliance with established protocols. The work includes obtaining and validating patient information from various sources and ensuring information entered into the ERM is accurate.

Principal Duties:

Registration and Scheduling 
1. Schedules patients using the applicable scheduling system for the department including routine and addon exams and complex radiological exams prior to the patient's arrival.
1. Completes registration screen via telephone or in person.
2. Collects accurate demographic and insurance information. Updates EMR as needed.
3. Counsels or refers patient to the financial clearing team for establishing insurance or method of payment.
4. Completes and/or transfers calls to appropriate areas as needed; Seeks appropriate resources to resolve 
difficult calls or refers to leadership.
5. Responds to patient portal or messaging center work lists, i.e. appointment requests, fax queues, email requests, etc.

Insurance Verification/Authorization 
1. Verify insurance eligibility using applicable eligibility system. Ensure that managed care carve outs (lab 
and radiology carve outs) are adhered to. 
2. Notify patient of the need for insurance referral form or pre-authorization prior to scheduled 
appointment.
3. Make recommendations for internal process improvements.
4.Performs related work as assigned

Customer Service: 
Greets customers in courteous, friendly, respectful and professional manner at all times, including maintaining eye contact when appropriate.
Follows communication protocols to both internal and external customers, including introducing him/herself with job title and experience, asking open ended questions, such as “How may I be of help to you?” using the customer’s name as soon as it is learned.
Responds promptly and appropriately to customer questions/concerns/complaints and attempts immediate resolution.
 Keeps customer’s information confidential, including public places such as elevators or the cafeteria.
Provides assistance and offers help immediately, including finding someone else to meet the request, if unable to do so him/herself. Introduce other staff to customers when a hand-off occurs and explain that the person will provide excellent service.
Demonstrates commitment to excellent service recovery when a customer’s expectations have not been met.

Commitment to Co-Workers:
Offers assistance to colleagues and other departments when needed.
Takes responsibility for solving problems regardless of origin; completes assignments, and respects deadlines.
Resolves conflict directly with colleagues and seeks assistance from others if the issue cannot be resolved. Refrains from criticism in public.
Mindful and respectful of others’ time and schedules. Attends meetings on time and communicates any absences. 
Provides co-workers with a status.

Communication Etiquette: 
Respectful, courteous and professional in all forms of communication and follows facility’s service communication protocol in all interactions.
Refrains from use of personal cell phone in patient care areas and keeps usage to a minimum at all other times while on duty.
Does not text or use e-mail during meetings (except for exigent or emergency situations).
Limits use of business cell phone during meetings (remain on vibrate and/or calls go to voicemail).
Makes every effort to answer telephone calls within three rings, introducing him/herself, department and title (if appropriate). Asks permission before placing the caller on hold or using the speakerphone. If caller is transferred, gives the caller the extension number of the person he or she is being transferred to. Offers further assistance to the caller upon completing the conversation.
Maintains an appropriate voicemail message and when away from the office has an out-of-office email message that is brief, current, and includes name and department and offers the caller options if possible.
Returns email and voicemail messages promptly but no later than within one business day (24 hours).
Always mindful of voice and language in public.

Self Management:
Participates in assigned educational programs within hospital and outside of hospital as assigned by the Program Coordinator to maintain optimum knowledge base to provide superior assistance to the Physical Medicine Residency Program. 
Reports to work appropriately groomed and in compliance with the Hospital’s dress code. Wears identification badge at all times at chest level and facing outwards so identification is clearly visible.
Complete all assignments within deadlines or negotiates alternative actions and time frames in order to achieve desired outcomes. 
Completes mandatory, annual education and competency requirements. 
Follows UMCRH safety, infection control and employee health standards. 
Demonstrates responsibility for personal growth, development and professional knowledge and competency.
Adhere to all UMCRH and department policies and procedures, including Code of Conduct and professional behavior standards. Does not exceed Hospital guidelines in reference to attendance, punctuality, and use of sick and unplanned absences. Provides notification of absences, lateness and vacation requests according to department guidelines. Respects length of time for lunch and break times. 
Reviews, signs, and adheres to UMCRH and/or departmental confidentiality statement.

Education/Knowledge 

• Attained Level: High School or GED
• Preferred: Some college level course work
• Completed Course Work/Program: Business, healthcare administration, social work, or related is Preferred.

Applicable Experience

• Experience (years): Required: One year Preferred: Three years or more
• Experience (describe required & preferred): At least 1 years of experience performing patient registration and scheduling, medical insurance screening and verification in an outpatient environment. Telephone call center experience preferred

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