SCO Appointment Agent

Job Description

Job Description

Southern California Orthopedic Institute

Job Description

Job Title: Appointment Agent 

Department: Call Center 

Reports to: Call Center Supervisor 

FLSA Status: Non-Exempt 

Job Summary: 

Provide exceptional customer service to patients and insurance carriers while scheduling appointments for consultations with all SCOI physicians in all office locations.

Essential Duties and Responsibilities: 

• Act in a manner that is indicative of team spirit and cooperation. 
• Model behavior that supports the Mission, Vision and Values of Southern California Orthopedic Institute. 
• Report to work as scheduled each day. 
• Comply with SCOI policies and procedures. 
• Collaborate effectively with all levels of SCOI personnel, including physicians, managers, and ancillary departments to ensure smooth appointment scheduling. 
• Answer calls through the appointment ACD Path. 
• Deliver outstanding customer service by providing knowledgeable and accurate information. 
• Schedule patients for consultations with SCOI physicians in all office locations. 
• Conduct an interview and gather crucial information from the patient, their insurance carrier and other relevant parties to offer optimal physicians’ choices and appointment scheduling for the patient’s injury or condition. 

• Injury 
• Condition 
• Insurance 
• Diagnostic Testing 
• Location 

• Registration of patient’s demographics 

• Create workers compensations cases 
• Establish cases requiring private authorization referral
• Registration of Adjuster and Nurse Case Managers 

• Understanding Private and Workers Compensation Insurance to differentiate between work-related and non- work-related injuries.
• Adheres to physician-specific guidelines when scheduling appointments for:

• New private patients

• New worker’s compensation patients 
• New IPA/HMO 
• QME, Panel QME, AME, IME, AOE-COE 
• Med/ Legals
• Follow up visits 
• Limited post ops 
• Some injections 

• Schedule appointments directly with insurance carriers. 
• Understanding the insurance matrix and staying current with the evolving Physician/Payer contracts. 
• Communicate with adjusters, nurse case managers and defense attorneys concerning workers compensation needs. 
• Email same or next day add-ons. 
• Send daily workers compensation status updates via fax within 24 hours of the DOS. 
• May be asked to perform other duties. 

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

Customer Service  

Manages difficult patient situations; Responds promptly to patient needs; Responds to requests for service and assistance. 

Professionalism  

Approaches others in a tactful manner; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions.

Interpersonal Skills 

Focuses on solving conflict, not blaming; Maintains confidentiality; Keeps emotions under control; Remains open to others' ideas and tries new things.

Teamwork  

Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Supports everyone's efforts to succeed.

Oral Communication  

Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions.

Written Communication  

Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.

Problem Solving  

Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in team problem solving situations; Uses reason even when dealing with difficult topics.

Technical Skills  

Strives to continuously build knowledge and skill, shares expertise with others.

Judgment

Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.

Motivation 

Sets and achieves goals; Demonstrates persistence and overcomes obstacles; Measures self against standard of excellence.

Planning/Organizing

Prioritizes and plans work activities; Uses time efficiently; Sets goals and objectives; Develops realistic action plans.

Quality

Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.

Quantity

Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.

Safety and Security

Observes safety and security procedures; Determines appropriate action beyond guidelines; Reports potentially unsafe conditions; Uses equipment and materials properly.

Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.

Attendance/Punctuality

Is consistently at work and on time; Ensures work responsibilities are covered when absent.

Dependability

Follows instructions, responds to management direction; Takes responsibility for own actions; Completes tasks on time or notifies appropriate person with an alternate plan.

Initiative  

Volunteers readily; Seeks increased responsibilities; Takes independent actions and calculated risks; Asks for and offers help when needed.

Qualifications  

To perfor