Call Center Representative

Call Center Representative

Call Center offers a $3 shift differential after 5pm and on the weekends

POSITION DESCRIPTION :

Answers incoming calls, assesses the urgency of the call, appropriately triages and directs urgent calls according to established procedures to ensure optimal quality patient care. Schedules patient appointments, communicates and coordinates scheduling with clinical personnel to optimize patient care and efficiency. Manages patient referrals and / or prior authorizations, by receiving requests from internal and external customers and ensures that all requests are processed correctly and in a timely manner. Provides a high level of customer service to all internal and external customers.

ESSENTIAL JOB FUNCTIONS : The following job functions may not be the responsibility of all Call Center Representative I’s. Some Call Center Representative I’s will be assigned work that has more focused responsibilities, depending on assigned shift.

• Answers incoming calls, assesses the urgency of the call, appropriately triages and directs urgent calls according to established procedures to ensure optimal quality patient care; may schedule appointments for urgent problems; communicates and coordinates scheduling with clinical personnel to optimize patient care and efficiency.
• Answers calls for Ancillary Services and determines criteria for inclusion of services.
• Pulls On-Call Report to verify providers are on-call for afternoon, evening and weekend shifts.
• Monitors Phone Queues to determine physician paging.
• Takes calls from (844) IHA-DOCS to get patient priorities for appointments.
• Accurately and competently pages appropriate on-call providers per protocols.
• Schedules patient appointments; obtains appropriate information, enters preliminary account data into Patient Chart.
• Completes Patient Pre-Registration prior to their appointment; creates charts.
• Prints SIOH Resources to enable outreach to patients to communicate resources available.
• Records messages for physicians and staff accurately, with complete information required, and ensures that it is tasked appropriately through IHA EMR system.
• Assists patients with MyChart-related questions. Keeps current on MyChart updates, changes and FAQ’s.
• Accurately completes the call center tool. Uses the call log and on-call MD calendar accurately and appropriately.
• Monitors Critical Radiology email box to communicate with hospital labs and physicians.
• Manages multiple In-Baskets on incoming orders.
• Monitors Vaccine Refrigerator to ensure correct temperatures.
• Reviews, monitors and performs follow up on all referral requests and authorizations for outpatient procedures and / or surgeries which may include contacting specialists, insurances, practices and patients.
• Obtains out of network authorizations whenever possible to help patient comply with Primary Care Provider requests.
• Accurately documents notes into IHA systems concerning the status of referrals, authorizations or other patient information; Answers patient, insurance and office calls related to referrals and prior authorizations.
• Maintains familiarity with physician office and Business Services department basic services and hours of operation to respond to customer request accurately and promptly.
• Ensures that any pending items received during the previous shift have been appropriately resolved.
• Performs other duties as assigned.

ORGANIZATIONAL EXPECTATIONS :

MEASURED BY :

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS :

EDUCATION : High school diploma or equivalent

CREDENTIALS / LICENSURE : None

MINIMUM EXPERIENCE : Up to 1 year previous experience in a combination of patient services, medical reception, call / customer service center (medical environment) or other relevant business environment.

POSITION REQUIREMENTS (ABILITIES & SKILLS) :

MINIMUM PHYSICAL EXPECTATIONS :

MINIMUM ENVIRONMENTAL EXPECTATIONS :

This job operates in a typical office environment which involves frequent interruptions and significant interaction with people which can be stressful at times.

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