CLIENT ENGAGEMENT SPECIALIST

Client Engagement Specialist

The Client Engagement Specialist is responsible for answering a high volume of telephone inquiries from patients and clients about available services at Care Resource, including Medical, Dental, Behavioral Health, and Case Management, following standard agency scripts and procedures. The CES is responsible for ensuring clients always receive efficient and courteous customer service, in a constant strive to improve service delivery. Furthermore, the CES Team serves as a support unit of the Client Engagement Services department; consequently, equally responsible for the processing of insurance eligibility for all Care Resource patients prior to schedule appointments and whenever applicable based on need. The Client Engagement Specialist will organize patients appointments, schedule procedures, and coordinate office visits according to physicians and patient's availability. Collect customers' feedback and resolves customers' issues quickly and effectively. The CES provides support to the medical, behavioral health departments and the PreP/PEP program to manage the flow of patients' care for all 4 locations, by pulling medical records and identifying the patients' needs to assist the best way possible. The CES identifies location and type of event to correctly schedule these appointments. Learning what other departments at Care Resource do and working with them on collaborative matters are concrete ways that a CES gains knowledge about the organization and works to better achieve its mission.

Patient/Client Services

• Answers the telephone promptly in a courteous and professional manner according to health center guidelines for providing exceptional customer service.
• Retrieves and returns dropped calls by listening to voicemails and provide the assistance needed.
• All queues' inboxes should be cleared by the end of each workday.
• Develops and maintains knowledge of all services offered and resources available at the health center.
• Resolves routine general questions and/or issues/concerns presented by patients and customers via phone, by following established organization's guidelines, scripts, and procedures.
• Uses computer systems to log and track inquiries, as well as, to monitor the status of pending items in need of follow-up, such as medication refills, and/or further intervention additional parties.
• Documents all customer interactions, including records details, complaints, comments, and actions taken.
• Obtains and enters/updates accurate demographic information into the agency Practice Management and, including address, telephone numbers, insurance information, etc.
• Uses EHR to verify pharmacy address, if referral is on file for patient to attend specialist appointment or if a lab order is on file to allow a lab appointment.
• Schedules patient/client appointments, including medical, behavioral, according to scheduling/color-coded templates, protocols/guidelines, credentialing grids, and PCP assignments.
• Cancels or reschedules an appointment upon a patient's request.
• Provides guidance and proper instructions to patients regarding requested services.
• Assists in the scheduling of interpreters for appointments requiring translation and/or sign language services.
• Reviews, updates, and confirms appointment information with the caller, including appointment date, time, and location, as well as, provider name, reason for the visit, and insurance status, always and before ending every call.
• Informs callers of necessary documentation needed on the day of appointment, including identification card, insurance card, proof of income (if applicable), medications, etc.
• Answers questions in the most courteous, caring, and professional manner, as well as, to offer any additional information as requested, or needed.
• CES conducts outbound calls to cancel, and/or reschedule patient medical appointments when the provider requests time off ahead of time, as well as, to provide additional assistance pertaining to accommodation of new appointments based on need.
• Scheduling appointments due to last-minute call-offs of providers will be handled by the medical Front Desk.
• Directs calls to other departments as needed.
• Documents the chart notes with clear guidance for the next person involved to understand previous actions taken.
• Escalates calls appropriately according to procedures.
• Maintains performance expectations including, but not limited to, Average Calls Answered, Average Handle Time (AHT), and other performance metric requirements.
• Complies with HIPAA rules and regulations when communicating with patients, clients, health center personnel, and external vendors.
• Makes sure, if needed, to verify all Commercial insurances, Medicare, Medicaid, and Ryan White for eligibility and benefits for future scheduled appointments, as well as, same day and walk-ins whenever applicable and based on need.
• Ensures that FQHC patients have proof of income on file before scheduling an appointment.
• Models Company culture of service standards in customer service, by providing gracious and efficient service with a sense of commitment, compassion, and competency to all our patients, as well as, to internal/external clients.

Culture of Service: 3 C's Compassion, Competency, Commitment

Safety

• Ensure proper hand washing according to Center for Disease Control and Prevention guidelines.
• Understand and appropriately act upon assigned role in Emergency Code System.
• Understand and performs assigned role in health center's Continuity of Operations Plan (COOP).

Other

• Provides outstanding customer service to both internal and external customers using the Health Center's 3C's of service.
• Participates in health center developmental activities as requested.
• Other duties as assigned.

Education

• High School diploma is required.

Skills

• Customer Focus, Advanced
• Enthusiastic, Advanced
• Courteous, Advanced
• Bilingual (English-Spanish), Intermediate
• Communication, Advanced
• Phone etiquette, Advanced
• Phone Systems, Advanced
• Windows, Advanced
• Interpersonal Skills, Advanced
• Team Player, Advanced
• Client Support, Advanced
• Customer Support, Advanced
• Customer Service, Advanced
• Active Listening, Advanced

Behaviors

• Dedicated: Devoted to a task or purpose with loyalty or integrity
• Team Player: Works well as a member of a group
• Enthusiastic: Shows intense and eager enjoyment and interest
• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

Motivations

• Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization
• Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals

Education

• High School or better.

Experience

• 2 years: A minimum of (2) two years of experience in customer service, call centers, or receptionist/scheduling positions; specifically, in healthcare settings, are required. Training in HIV/AIDS preferred.