Patient Services Agent / Representative (Customer Service)

Job Description

Job Description

Patient Services Agent / Representative (Customer Service)

Schedule : Mon – Fri, 8am – 5pm

The Patient Service Representative provides customer service to the company’s Medicare and Medicaid members to ensure patient satisfaction.

Duties and Responsibilities

1. Answer telephone calls in a timely and politely manner, preferably within three rings.
2. Make follow up calls regarding PCP appointments.
3. Ensure that reminder calls are made.
4. Assist with new PCP appointments if needed.
5. Call patients regarding missed appointments in order to improve services and customer experience.
6. Produce No Shows Report and submit to the Director of Patient Services which will be provided to upper management.
7. Make welcome call to inquire about the level of satisfaction with CMG’s services and current health plan.
8. Assist in anything patients require – from checking enrollment status to making PCP appointments.
9. Help clear any lack of information or follow up by the Broker.
10. Ensure that a tour of the center was given at the time of enrollment.
11. Produce Daily Reports regarding the progress of the call sessions.
12. Check of status of PCP appointment.

Key Responsibilities

• Deliver high-touch, white-glove customer service to patients and seniors with patience, empathy, and professionalism
• Manage 70–100+ inbound patient calls daily while maintaining quality and efficiency
• Navigate multiple systems simultaneously, including EHR platforms, scheduling systems, insurance verification tools, and telehealth applications
• Verify and update patient demographics, insurance information, and medical records accurately
• Schedule appointments, coordinate follow-up care, and assist patients with healthcare navigation
• Communicate important patient updates and concerns to providers and clinical teams promptly
• Maintain detailed and accurate documentation while ensuring HIPAA compliance at all times
• Resolve patient concerns with compassion and a solutions-oriented approach
• Create a positive and supportive experience for every patient interaction

Patient Services Agent / Representative (Customer Service)

Qualifications
Education/Experience:

1. Must have High school diploma or equivalent.
2. Prior experience in customer service and/or clinical setting.
3. MS Office programs experience.
4. Bilingual skills (English/Spanish).

Skills:

1. Use relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
2. Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines and standard accepted practices
3. Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
4. Ability to work with individuals within and outside the organization, in professional and courteous manner.
5. Must develop constructive and cooperative working relationships with others.
6. Understand written sentences and paragraphs in work related documents.
7. Strong ability to use independent judgment and initiative.
8. Organized and able to manage competing priorities.
9. Resourcefulness in problem solving.
10. Actively look for ways to help people.
11. Strong written and verbal communications skills.
12. Knowledge of medical terminology.
13. Must be extremely detail oriented.
14. Strong organizational and interpersonal skills.
15. Knowledge of EHR preferred.
16. Bilingual skills (English/Spanish).
17. Must develop constructive and cooperative working relationships with others.

 

What We’re Looking For

1. Strong customer service and communication skills
2. Ability to multitask and remain organized in a high-volume call center environment
3. Experience working with seniors, Medicare patients, healthcare, or customer support preferred
4. Comfortable navigating multiple systems and technology platforms in real time
5. Detail-oriented with strong problem-solving abilities
6. Passion for helping others and delivering exceptional patient care experiences

 

Nature of Work

1. Job duties are routine in nature, but situations may very occasionally; policy and procedure provide direction for solving non-routine situations.
2. Job duties involve routine interaction with others. Contacts are generally non-confrontational.
3. May be required to perform the duties of other employees, including supervisors/managers, in their absence.
4. May be required to perform duties and responsibilities not listed in this description, on a temporary or long-term basis.

 

Working Conditions
Performs work in a fast-paced office environment.

Patient Services Agent / Representative (Customer Service)

Benefits & Perks

• 17 PTO Days
• 11 Paid Holidays + 1 Floating Holiday
• Medical, Dental & Vision Insurance through UnitedHealthcare
• 401(k) with Employer Match
• Company-Paid Life Insurance
• Career growth and professional development opportunities

\nCompany Description

PrideStaff is a national staffing organization, delivering innovative solutions to the challenges employers face every day. Over the years, PrideStaff has been a consistent industry leader, developing technology and service processes that allow our organization to deliver superior performance. With locations across the United States, we're well positioned to partner with clients and candidates to ensure a successful match of employee talent with customer needs. When it comes to your success, we leave nothing to chance!

Our Mission: Consistently provide client experiences focused on what they value most.

Company Description

PrideStaff is a national staffing organization, delivering innovative solutions to the challenges employers face every day. Over the years, PrideStaff has been a consistent industry leader, developing technology and service processes that allow our organization to deliver superior performance. With locations across the United States, we're well positioned to partner with clients and candidates to ensure a successful match of employee talent with customer needs. When it comes to your success, we leave nothing to chance! \r\n\r\nOur Mission: Consistently provide client experiences focused on what they value most.