Customer Service Representative

Creating Life Better Here Starts With You

At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.

The Customer Service Representative is entrusted to provide excellent service and set a positive tone for every customer while serving as the liaison between patients and clinic staff, and demonstrating self-confidence, adaptability, and personal initiative. The CSR coordinates the customer encounters and serves as the communication hub for the clinic, in an attentive, courteous, and competent manner.

Required Behaviors:

As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization: Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability, and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.

Required Qualifications:

High school diploma or GED

Articulate; good communication skills; good grammar and spelling

Good problem solving skills

Knowledge of computer keyboard operation

Medical Terminology course required within 90 days of employment

Preferred Qualifications:

Previous medical background

Previous receptionist, clerical, and/or secretarial experience

Duties and Responsibilities:

Each Clinic serves a unique purpose. Individual CSR positions include all or some of the following:

Customer Service:

Establishes and maintains effective relationships with all internal and external customers, who may include patients, physicians, other healthcare providers, co-workers, vendors, and visitors

Communicates, face to face and by telephone, with internal and external customers in a professional and courteous manner

Maintains a positive attitude and remains calm under pressure, while working in a fast-paced environment

Focuses on continuous improvement to meet customer needs; supports new programs, ideas, and processes

Maintains sensitivity to others and adjusts behavior accordingly

Recognizes the importance of teamwork and effectively participates in teamwork processes

Presents a professional appearance and acts as a positive representative of the clinic

Patient Check In and Check Out:

Enters data correctly and efficiently, including demographics and patient insurances

Maintains medical records, reports, and files as required

Answers multiple phone lines with courtesy and efficiency; takes and distributes messages; properly refers calls to providers and other staff members

Collects balances due from patients, including co-pays, co-insurances, and outstanding balances

Performs accurate accounting of daily deposits and verification of cash on hand

Generates daily reports and verifies the accuracy of the data reported

Discusses financial responsibility with patient and/or guarantor and sets up payment arrangements in accordance with SJRMC policies

Follows protocol for opening and closing clinic

Appointment Scheduling:

Demonstrates competency in the Scheduling Module and performs scheduling as per physician-specific protocol

Insurance Verification:

Verifies patient insurance coverage in accordance with clinic protocol and demonstrates competencies in both manual and electronic verification methods

Billing Rejections:

Processes billing rejections in a timely and accurate manner

Mail Processing:

Processes mail each day in an accurate and timely manner

Charge Entry:

Posts charges and/or payments timely and accurately

Works collaboratively with clinical staff to ensure appropriate CPT and ICD-9 coding for all patient encounters

Resolves coding issues with the clinical staff promptly

Referral and Authorization Management:

Obtains referrals, pre-certifications, and authorizations in a timely and accurate manner, following payer specific requirements; maintains accurate documentation

Medical Records:

Demonstrates ability to properly prepare, process, and file Medical Records

Maintains filing system

Provides correspondence and Medical Records to appropriate parties in a timely manner; processes all requests for Medical Records in a timely manner and in accordance with clinic protocol

Scanning:

Performs scanning duties in a timely and accurate manner

Additional Responsibilities:

Complies with and is knowledgeable of organizational and departmental policies and procedures, including safety procedures and policies

Contributes to the care of the environment by maintaining work areas and assisting with housekeeping tasks as needed

Utilizes computer system as needed for information, data analysis, and to complete tasks

Maintains customers' rights (confidentiality, privacy, safety, security, and decision making)

Attends departmental meetings and other in-services and training sessions relative to job

Performs basic tasks in a timely manner with minimum guidance and supervision

Assures that appropriate levels of office supplies are maintained

Demonstrates willingness to work toward departmental and organizational goals and objectives; is committed to the successful operation of the clinic

Each employee is responsible for implementing SJRMC's Service Standards into their daily work:

Safety, Courtesy, Effectiveness, and Stewardship

Other duties as assigned

Physical Demands and Environmental Work Conditions:

Must be able to lift greater than 50 pounds and push 0-300 pounds frequently

Must be able to see with corrective eyewear and hear clearly with assistance

Must be able to sit and walk frequently or for long periods of time; must be able to stand, bend, squat, climb, kneel, and twist routinely

Extensive computer keyboarding occurs daily

Special Demands:

Sets limits when dealing with angry, hostile, or sometimes verbally or physically abusive patients and families in an attempt to ensure a safe, respectful environment that will support the delivery of care

Some exposure to disease may occur

Effectively copes and strives for balance when caring for acutely ill patients and families

Specific Clinic Requirements:

Urgent Care: willing to work 12 hour shifts, weekends, and holidays

San Juan Pediatrics: willing to work evening and Saturday shifts as assigned

San Juan Regional Medical Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.