Call Center Representative - Primary Care

Location: Silver Spring, MD
Remote: No
Schedule: Variable shifts from 8:00 AM to 5:30 PM, Monday to Friday. One late shift per week from 11:30 AM to 8:00 PM. Saturday shifts from 8:00 AM to 4:30 PM.
Register and schedule patients' appointments by telephone utilizing the physician scheduler and individual departmental guidelines. Communicate with
parents, patients, physicians, community doctors/staff and other staff in a courteous manner. Responsible for obtaining and validating patient
information from various sources and to ensure information entered into the computer management system is accurate. Promote customer service
environment.
Qualifications:
Minimum Education
High School Diploma or GED (Required)
Minimum Work Experience

• 1 year Experience performing patient registration and scheduling, medical insurance screening and verification. (Required)
• Equivalent customer service or call center experience and education can be considered in lieu of patient registration, scheduling, insurance screening and verification experience.
• Experience in healthcare setting preferred.
• Telephone call center experience helpful.

Functional Accountabilities
Registration and Scheduling Services

• Provide client support to parent/guardian via phone for any or all of the following: on-line registration help; scheduling, rescheduling and/or canceling of appointments whether by parent/guardian or department; inform patient/parent of any departmental scheduling guidelines associated with appointment; reschedule all appointments related to clinic maintenance cancellation.

• Notify parent of the need for completed insurance referral form or any pre-authorization of treatment prior to scheduled appointment; discuss co-payment or payment in full requirements; counsel or refer parent to central business operation's financial counseling or establish a payment plan.

• Complete calls in an accurate and timely manner; transfer calls to appropriate areas as needed; notify manager/supervisor of difficult calls (clarification re insurance, problem callers, etc.); seek appropriate resources to solve problems effectively.

• Anticipate customer service needs to "prevent fires."

• Enter appropriate notes in the system; obtain necessary information for accurate and complete documentation of all registration printouts, consent documents and other forms.

• Anticipate customer service needs to "prevent fires."

Verifying Insurance/Authorization and Process Improvement

• Work with insurance companies to verify insurance eligibility and coverage for anticipated services using EVS, ENVOY, Mamsi-online, UHC and calling insurance; obtain authorization and benefit information from insurance companies as appropriate; document authorization and information in Account Notes and fields.

• Collect and verify demographic, PCP/referring physician and insurance information.

• Make recommendations for internal process improvements.

Safety

• Speak up when team members appear to exhibit unsafe behavior or performance

• Continuously validate and verify information needed for decision making or documentation

• Stop in the face of uncertainty and takes time to resolve the situation

• Demonstrate accurate, clear and timely verbal and written communication

• Actively promote safety for patients, families, visitors and co-workers
• Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance