Call Center Representative

DEPARTMENT: Call Center
REPORTS TO: Call Center Supervisor
Summary:
 
The primary purpose is to provide excellent customer service and courtesy to all inbound calls at our call center. The responsibility is answer and screens phone calls for all other departments, route calls as appropriate within established guidelines. Accurately record messages and deliver to the appropriate party in a timely manner; check voicemails periodically
 
Call Center is responsible for the efficient and effective scheduling of site appointments. Answer incoming telephone calls from patients and physician offices calling to schedule Medical, Dental, CPSP, Optometry, Chiropractor, Behavioral Health, vision and transportation appointments. Secures patient information for charting, billing and record keeping purposes. Ensures that established information is obtained in order to pre-register patients. Representative must be able to identify any schedule conflicts and take appropriate action to ensure smooth patient flows and the highest level of resource utilization possible.
 
Summary of Responsibilities:
 
· Overall knowledge of the revenue cycle process, from appointment scheduling, registration, insurance verification, pre-certification, billing compliance, payer contracts, patient estimation, financial assistance.
· Schedules appointments per established guidelines and educates on UHC services.
· Obtains updated insurance and demographic information.
· Answer incoming calls on a multi-line phone.
· Obtaining/updating patient charts with registration and eligibility documentation.
· Providing outstanding customer service to internal and external customers
· Reporting any potential customer concerns or complaints immediately to supervisor.
· Utilizes protocol for patient look up to ensure accurate identification of patient to ensure data integrity and patient safety.
· Will ensure no patient is turned away. Will use all resources to secure an appointment for patient.
 
PERFORMANCE AREA 1:
 
a. Representative will review patient’s request for appointment and schedule according to established guidelines for service and site.
b. Representative will obtain patient demographics in order facilitate pre-registration department to select proper payer.
 
PERFORMANCE AREA 2:
 
a. Will perform other duties as assigned by supervisor.
b. Will conduct regular audits of work to ensure quality work.
c. Supports UHC customer service expectations by providing benefit and contact information to patients and staff when issues/concerns arise.
d. Supports team development by keeping current on internal and payer changes as they occur and communicates changes within the group.
 
General Corporate Expectations:
a. Attends and actively participates in all meetings (e.g., department meetings, program meetings, employee staff meetings) and other activities as required or assigned
b. Attends workshops/seminars as necessary to increase skills and knowledge to provide effective care, treatment, and/or leadership.
c. Supports the overall needs of the health center by working flexible or extended hours when necessary.
d. Displays a positive, professional and respectful demeanor at all times toward employees, peers, professional contacts, and patients served, maintaining a professional appearance and positive image for the health centers.
e. Contributes to the team by promoting positive staff interaction, maintains open communication with other programs/departments.
f. Demonstrates awareness of, and compliance with, organizational mission and objective of UHC to provide health care access and support services for all members of the community.
g. Supports their own staff development by completing the required hours of continuing education each year.
h. Other work-related duties as assigned by supervisor. Duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.
i. Being able to work a flexible schedule based call center needs including weekends with rotating shifts,
j. Maintains confidentiality and respect for information regarding patients and other team members; abides by UHC Rules of Confidentiality and general HIPAA regulations regarding privacy.
 
QUALIFICATION REQUIREMENTS:
 
EDUCATION AND LICENSE/CERTIFICATION:
 
· High School Graduate. Associates Degree preferred.
· Typing Certificate
 
PRIOR EXPERIENCE:
 
· Minimum 2 years of experience in a health center setting or customer service.
· Knowledge in scheduling or call center environment.
· Knowledge of billing processes and coding preferred.
· Demonstration of strong understanding of UHC front office processes and patient intake.
 
SKILLS
 
· Customer-service oriented
· Excellent telephone etiquette
· Excellent listening and Customer Service/Interpersonal skills
· Bilingual (English/Spanish,) required.
· Able to quickly build and maintain rapport with patients and providers of differing backgrounds Typing Skills 60 WPM
· Team player
· Ability to handle sensitive and confidential information
· Ability to articulate complex information
· Strong relationship management skills must be able to multitask and be able to diffuse difficult situations
· Positive professional insight.
· Flexibility and dependability (Availability for nights and weekends)
· Strong computer skills.
· Positive professional insight.
· Flexibility and dependability.
· Demonstrated good problem-solving skills; sound judgment
· Effective leadership/supervisory skills
· Modern office practices and procedures including email (Microsoft Outlook)
· Intermediate computer skills
· Attention to detail and excellent follow-through on work tasks
· Able to handle multiple tasks simultaneously
 
PHYSICAL REQUIREMENTS
 
· Must be able to lift up to 20 pounds and push up to 50 pounds (on wheels).
· Must be able to hear staff on the phone and speak clearly in order to communicate information to patients and staff.
· Must be able to read memos, computer screens, personnel forms and clinical and administrative documents.
· Must have high manual dexterity.
· Must be able to reach above the shoulder level to work, must be able to bend, squat and sit, stand, stoop, crouch, reach, kneel, twist/turn
 
Additional job information:
 
Hours of Operation: Must be available to work non-standard hours and overtime based on work volume. Hours of operation are 8:00AM to 8:00 PM, schedules may vary. Must be flexible with their start and end times, as work hours will be based on the business needs of our internal and external customers. May be required to rotate and work a variety of shifts, may include weekends and Holidays.
 
Travel: may be required to travel to other health centers and community events.