Call Center Pt. Servc. Rep., Primary Care

Overview:

Tekwissen Group is a workforce management provider throughout the USA and many other countries in the world. This client is a locally based, nonprofit healthcare organization. Their health system includes two hospitals, a 100-provider primary and specialty care medical group, a cancer center; and a new medical fitness center.

Job Title: Call Center Pt. Servc. Rep., Primary Care

Location: Fairfield, CA, 94534

Duration: 3 Months

Job Type: Contract to Hire

Work Type: Onsite

JOB SUMMARY:

Duties:

• The Call Center Patient Services Representative performs general office duties including appointment scheduling, determining and verifying insurance eligibility, and processing of detailed messages to physicians.
• The Patient Services Representative functions as part of a clerical, clinical, and customer service team in support of primary care practices.,

Skills:

• Registration and Charge Entry
• Gathers, updates and verifies a comprehensive package of registration and insurance/payer information and ensures accurate entry into the practice management system.
• Provides information to patients regarding the selection process for a primary care physician, assists in determining insurance eligibility, co-payments, share of costs and other financial responsibilities for services rendered.
• Verifies and documents eligibility for all payers.
• Reviews benefit plan/s with patient to determine specific allowances and/or restrictions based on services requested.
• Researches and answers inquiries related to claims, eligibility and referrals.
• Ensures the accuracy of demographic and insurance information in accordance with the policies, procedures and service expectations of each department.
• Maintains professional standards by actively participating in committees, inservices and QI activities and standards development.
• Acts as a resource to new and existing staff in personal areas of subject matter expertise.
• Presents a professional demeanor in appearance and attitude.
• Floats to other areas as needed.
• Performs other duties as assigned.

Appointments and Reception:

• Obtains complete demographic information for new patients ensuring accurate entry into the practice management system. Confirms/updates demographic information for existing patients.
• Confirms eligibility/PCP assignment status for patients with WHA, Health Net or Solano Partnership insurance prior to scheduling appointment.
• Demonstrates effective listening skills to determine appropriate call routing.
• Schedules appointments on the phone in accordance with approved provider protocols and current scheduling policies, procedures and algorithms.
• Monitors provider schedules to ensure appointments are booked for correct type and correct time allocation.
• Places confirmation or rescheduling calls in accordance with scripted guidelines and current policy and procedures.
• Assists in physician schedule maintenance functions including coordination of physician absences with open appointment times.
• Gathers data and performs provider access audits.

Medical Records:

• Adheres to System policies related to confidentiality of medical record information, transcription and copies or distribution of medical record content.
• Handles patient documents appropriately to ensure patient confidentiality.

Education:

• High School Graduate or equivalent preferred. Some college business or computer course work essential.

Licensure/Certification:

• AHA BLS certification required within 60 days of hire. Course work in medical terminology preferred

Experience:

• 1-2 years working in a healthcare environment required.
• 6 months of direct client Call Center training/experience can be substituted for healthcare experience.
• 1-2 years direct experience working in a call center environment preferred.
• Strong experience in insurance verification preferred.
• Strong communication skills and dynamic customer service experience preferred.

Skills:

• Strong organizational and written and spoken communication skills essential.
• Demonstrated mastery of practice management systems is required with CPT, ICD9 coding experience beneficial.

Experience in the following areas preferred:

• appointment scheduling, registration process, insurance verification, primary care preventive care.
• Demonstrated ability to work independently on a variety of complex tasks, managing competing deadlines.
• Bilingual capability preferred.

Interpersonal Skills/Customer Service:

• Demonstrates the client Way.
• The client Way is a set of value-based behaviours that are to be consistently demonstrated and role modeled by all employees that work at client.
• The client Way principles consist of Caring, Communication, Collaboration, and Competence.

Hours:

• Based on business need.

Physical Effort:

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Walking, some bending, stooping, and lifting.
• Position requires extensive use of computer keyboarding throughout the day.

TekWissen® Group is an equal opportunity employer supporting workforce diversity.