Patient Services Representative Specialist

Job Title

In collaboration with patients, families (as defined by the patient) and staff across all disciplines and departments is responsible for serving as the initial point of contact for new and established CommUnityCare patients.

Responsibilities

Essential Duties:

• Provide exceptional customer service to all patients, including but not limited to, scheduling and confirming appointments, using a multiline phone, and performing data entry into the EPIC Electronic Practice Management (EPM) system.
• Accurately and promptly schedule, reschedule, and cancel physician patient appointments for the convenience of the patient and/or their representative.
• Maximize CommUnityCare resources through efficient scheduling practices.
• Appoint and know protocols/practices for CUC specialty clinics. Use independent judgement combined with protocols to appoint a variety of specialty clinics across the organization.
• Interview new patients and/or their representative to identify the proper match with a CommUnityCare clinic and primary care provider (PCP). Gather patient demographic and insurance information to begin the scheduling process.
• Identify urgent scheduling needs and prioritize them with the appropriate clinic.
• Resolve patient inquiries, including explanation of:
  • Benefits and eligibility information
  • Billing and payment options
  • PCP selection
  • Specialty clinic protocols and procedures
  • Authorization for treatment
  • Facilitate connection to financial screening services.
• Perform other duties as assigned.
• Ensure a positive patient experience through professional interaction with patients and proper phone greeting etiquette. Maintain strict confidentiality of personal health information (PHI).
• Maintain patient experience metrics (including talk time, wrap up time, call abandonment, wait time between incoming calls and wait time before call is answered) below targeted levels.
• Obtain satisfactory scores on PNC-related items on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Patient-Centered Medical Home (PCMH) and any other survey tool.
• Schedule appointments accurately and efficiently, using established guidelines for open access and load leveling.
• Understand intricacies of specialty appointing, protocols, and appoint to a variety of specialty procedure schedules.
• Follow standardized patient scheduling practices, utilizing telephone scripts as provided.
• Maintain a positive and flexible attitude, cooperate and work collaboratively to help others.
• Embrace diversity throughout the workplace with patients, their families, and co-workers by making a genuine effort to understand the needs of others.
• Collaborate with all departments and divisions of CommUnityCare to provide patient-centered care.
• Follow the CommUnityCare Code of Conduct and exhibit CommUnityCare Core Values at all times

Knowledge/Skills/Abilities

• Knowledge of appointment scheduling and insurance verification procedures.
• Minimum 6 months experience appointing primary care for CommUnityCare
• Must meet or exceed metric evaluation scores
• Ability to implement Open Access principles, including load leveling.
• Strong customer service skills, including the ability to resolve patient complaints or refer them appropriately to the manager/supervisor.
• Working knowledge of the EPIC EPM/EMR Systems and standard Microsoft Office tools, including Outlook, Word, and Excel.
• Bilingual (English/Spanish) strongly preferred
• Ability to multitask while working in a fast-paced environment.

Qualifications

MINIMUM EDUCATION: High school diploma or equivalent.

MINIMUM EXPERIENCE:

• Minimum of 1 year previous experience in a medical or call-center setting required.
• Previous scheduling, registration, billing, or administrative assistant experience preferred