Answer incoming clinic calls within established company guidelines to provide prompt and courteous customer service to callers. Complete scheduling for clinic providers and ancillary staff for multiple clinic and multiple Markets or Specialty groups. Complete insurance entry and verification. Handle clinical calls and communications to clinic staff, escalating when needed. Manage outbound calls and incoming calls from company campaigns.
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ESSENTIAL JOB DUTIES
- Assist as a resource for new hires
- Answer incoming calls for all assigned clinics and operate call center telephony platforms.
- Follows scheduling protocols and guidelines. Utilizes critical thinking to determine which processes to apply to specific situations.
- Determine calls with urgent needs and complete warm transfer to clinic staff
- Accurately schedule for Specialty and PCP practices and correctly handle complex rule sets across multiple Medical Groups and Markets
- Maintain optimal productivity for call handling and wrap-up.
- Ensure and request appropriate referrals and/or authorizations are present for specialty care. Maintain knowledge of insurance-specific referral and prior authorization requirements.
- Researches patient requests in the medical record and provides information to patient or other entity.
- Obtain information regarding refills, clinical questions, referrals, services, etc. Enter documentation and communication within EMR for non-urgent clinical calls
- Monitor assigned boxes in EMR for return communication from the clinic
- Accurately validate and enter patient name, DOB and demographics
- Collects insurance and pre-certification information from callers, validates insurance eligibility and correct PCP assignment. Determines appropriate and current referrals are present, as indicated
- Adheres and complies to all policies and procedures
- Attend educational sessions and department meetings as scheduled
- Ability to perform all other duties as assigned or requested
- High school diploma or equivalent required
- 1 + years business office experience in patient scheduling required.
- 2 + years business office experience in patient scheduling preferred.
- Additional education in business management, healthcare mangagement or closely related field may substitute for the required experience on a one-for-one year basis.