Call Center Specialist

JOB SUMMARY

The Call Center Specialist is the main link between our external customers and Memorial Healthcare. The Call Center Specialist will serve as a role model to other employees for exhibiting excellent customer service skills and effective communication. The Specialist's primary responsibility will be scheduling procedures, tests and other services, to include coordinating multiple procedures to best meet the patient's needs and department availability. Information regarding the needed preparation for the appointments will also be provided to the patient and/or the physician's office. The Call Center Specialist will act as a liaison for all customers and be knowledgeable in organizational and community initiatives. S/he will also perform insurance verification, medical necessity and pre-registration job responsibilities. Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience. Recognizes and demonstrates understanding of patient and family centered care.


PRIMARY JOB RESPONSIBILITIES

1. Demonstrates knowledge of, and supports, Memorial Healthcare's mission, vision, value


statements, Standards of Behavior, policies and procedures, operating instructions, HIPAA Privacy and confidentiality standards, corporate compliance plan, code of ethical behavior and commitment to service excellence.


2. Applies excellent customer service skills while answering the phone to schedule procedures, tests or other services accurately and timely.


3. Demonstrates the knowledge and skills necessary to provide services appropriate to the age of patients.

4. Interviews patients and/or their family members, physicians and/or their office staff to accurately obtain data to schedule, register and obtain insurance verification.

5. Instructs patients and/or their family members and/or physicians and/or their office staff on the approved exam order and patient preparation.

6. Verifies patient insurance eligibility for services at the time of service or prior to, if services are pre-scheduled and require pre-certification or verification.

7. Pre-registers patients and follows medical necessity guidelines for Medicare's advance beneficiary notices and other payer requirements.

8. Is proactive in asking for patient liability in regards to copays, co-insurance and deductibles prior to services being rendered.

9. Can assist the patient and family by directing them for financial assistance.

10. Remains well versed in all computer applications as pertains to job responsibilities.


11. Acquires and maintains knowledge of all third party payer insurance information.


12. Participates in training programs and educational activities as indicated.

13. Provides creative problem solving when situations arise. Is proactive in potential difficult situations.


DEPARTMENTAL AND ADDITIONAL JOB RESPONSIBILITIES

1. Assesses departmental priorities and fills in as indicated.

1. Will be cross trained in billing and accounts receivable in order to answer questions as pertains to the Call Center.
2. Participates in the quality improvement process, in service and continuing education activities.
3. Other duties as assigned.

JOB SPECIFICATIONS

EDUCATION

1. High School graduate or GED required and post-high school courses in medical terminology and/or anatomy and physiology or documented knowledge and experience required. Associates degree preferred.

EXPERIENCE

1. Documented excellence in customer service. Professional telephone and written communication skills required. Word processing and computer skills required. Previous medical office, scheduling, insurance verification and/or registration experience required.
2. Displays professionalism to all internal and external customers. Customer satisfaction oriented. Excellent communication and grammar skills required. Knowledge of insurance, billing, and payment methods preferred. Computer skills required. Ability to interact with the public in a calm and professional manner. Familiar with the functions and locations of various departments.

ESSENTIAL PHYSICAL ABILITIES/MOTOR SKILLS

1. Able to travel independently throughout all Memorial Healthcare facilities.
2. Ability to sit and/o r stand for long periods of time.
3. Small motor skills required for operating modern computer, office, and telephone equipment as utilized by Memorial Healthcare (MHC).

ESSENTIAL TECHNICAL ABILITIES

1. Proficiency using modern office, computer and telephone equipmentas used by Memorial Healthcare.
2. Ability to enter and retrieve data from hospital information system, ability to operate phone system, operates modern office equipment and do minor maintenance repair and/or programming.

ESSENTIAL MENTAL ABILITIES

1. Ability to adapt and maintain focus in fast paced, quickly changing or stressful situations. Particularly during a telephone conversation.
2. Ability to read and interpret a variety of documents including, but not limited to policies, operating instructions, white papers, regulations, rules and laws.
3. Ability to prioritize daily work responsibilities to accomplish the department's goals and objectives. Must be self-motivated and able to work independently/and a team player.

ESSENTIAL SENSORY REQUIREMENTS

1. Able to see for the purpose of reading information received in formats including but not limited to paper, computer, reports, bulletins, updates, manuals.
2. Able to see and hear for work-related purposes.
3. Ability to converse in a calm and friendly manner, ability to effectively communicate on the phone.

INTERPERSONAL SKILLS

1. Ability to interact with co-workers, hospital staff, administration, patients, physicians, the public and all internal and external customers in a professional and effective, courteous and tactful manner, at all times, physically, verbally and in all written and electronic communication.
2. Required to remain calm when adversity is encountered.
3. Open, honest, and tactful communication skills.
4. Ability to work as a team member in all activities.
5. Positive, cooperative and motivated attitude.
6. Good guest relation skills

1. Must possess helpfulness, patience and tact in communications, whether in person, on the phone or computer applications.