HIM Call Center Agent

Job Description

Job Description

SUMMARY

Under the direct supervision of the Practice Administrator, the Health Information Management (HIM) Call Agent will answer phones, schedule appointments, process referrals, direct schedule into other service areas and relay accurate information to appropriate care teams.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Answer all incoming calls with the standard greeting.
• Display exceptional customer service skills and assist the patient to the best of your ability.
• Agent’s primary responsibility is to be logged into the phone system at all times, focusing on meeting organizational goals and Service Level Agreements.
• Ability to accurately document messages and route to the appropriate care team in real-time.
• General knowledge of the organization and departments to ensure proper routing of messages.
• Ability to follow policies and procedures to ensure all urgent calls are handled and passed off appropriately.
• Ability to follow detailed guidelines and appropriately schedule patients with providers and resources.
• Skilled in multitasking and ability to prioritize urgent needs.
• Possess strong active listening skills.
• Monitor Inbasket messages and emails.
• Build positive relationships by going above and beyond with customer service, ensuring that all questions, cancellations, and confirmations are handled appropriately
• Identify opportunities to assist patients in various parts of their healthcare needs.
• Ability to attempt conflict resolution and determine when it’s appropriate to escalate.
• General understanding of payers that Montage Medical Group is credentialed with and appointment types that patients may be eligible for.
• Assist Physicians and Medical Assistants as needed.
• Perform rescheduling and schedule management as assigned by practice manager or supervisor.
• Displays effective communication skills with vulnerable patient populations. Vulnerable populations are patients who are made vulnerable due to their:
  1. Financial circumstances
  2. Place of residence
  3. Health
  4. Age
  5. Personal characteristics
  6. Functional or developmental status
  7. Ability to communicate effectively
  8. Presence of chronic illness or disability
• Adheres to team-based approach in patient care.
• Adheres to patient-centered medical home policies and procedures in conjunction with NCQA guidelines.
• Attends mandatory staff meetings and huddles.
• Ability to follow strict guideline and accurately schedule patients directly into other service areas.
• Knowledge of scheduling guidelines across all MMG specialties
• Knowledge of coverage requirements and authorization process and ability to explain to patients

SUPERVISORY RESPONSIBILITIES

This job has no supervisory responsibilities.

MONTAGE VALUES

Employees of Montage Medical Group are expected to uphold the Montage Values and Service Standards. Montage Medical Group employees find joy in caring for those we service, are dedicated to coordinating care across all settings, take ownership, collaborate to deliver the highest quality care and are entrusted to serve our community with respect

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

High school diploma or general education degree (“GED”); and at least three months (preferably six months) related experience ( e.g ., health care setting, customer service, etc .) and/or training; or equivalent combination of education and experience.

Experience with medical terminology ( e.g ., CPT and ICD9 codes) and understanding of medical insurance process preferred and extremely helpful. Must understand or quickly learn about the differences between and among self-pay patients, insured patients, Medicare and Medicaid patients, workers’ compensation patients, and occupational medicine patients.

Must respond courteously, sympathetically and maturely to patient needs. Must be neat and professional in appearance . Detail oriented and well organized. Computer literate ( i.e ., be familiar with a PC and basic software, such as Microsoft Windows, Microsoft Word, etc.) Bilingual may be required. Must be able to work under pressure and in stressful situations and must be able to work quickly when business conditions warrant.

PATIENT SERVICE, ATTITUDE AND LANGUAGE SKILLS

The employee performing this position is expected to have superior patient service, speaking skills and a professional attitude. One of Montage Medical Group’s core values is we are a “Patient-Centered” practice. High patient satisfaction and whole-person care are of critical importance and all employees must strive to achieve 100% patient satisfaction and quality outcomes for all patients. All communications to co-workers, patients and clients must be courteous (e.g., “Mr. Smith, the Medical Assistant will show you to one of the exam rooms now.”)

The employee performing this position is expected to be able to speak clearly and effectively communicate with patients and co-workers. The employee must respect, understand and observe the importance of patient confidentiality. He/she is expected to abide by the company’s HIPAA privacy policy.