APR Consulting, Inc. has been engaged to identify a Call Center Service Representative

Location: Hillsboro, OR 97124

Position: Call Center Service Representative

Pay Rate: $23/hr

Duration: 3 months

Work shifts will be between 7am-8pm/7 days week., Shifts will be provided during training.

Since 1980 APR Consulting, Inc. has provided professional recruiting and contingent workforce solutions to a diverse mix of clients, industries, and skill sets nationwide.

Our client is one of the largest non-profit health plans founded in 1945 which offers comprehensive, affordable health coverage plans for individual & family, Medicare, employers, and large group.

Job Summary:

Appointing:

• Review medical chart to appoint according to scripts and guidelines., Schedule/reschedule/cancel appointments for services, according to scripts and guidelines., Places calls for appointment reminders and quality measure outreach.
• Collect care specific information for Primary Care or Specialty Care services.
• Messaging: Review medical chart to collect information for messages to send to health care team.
• Routes incoming calls from patients, physicians, nurses, and other departments according to scripts and guidelines.
• Answers routine administrative inquires., Forwards medical and other complex inquires to appropriate personnel.
• Take messages as necessary.
• Manage electronic in-basket in multiple system applications.

General Services:

• Assist patients by providing phone numbers, facility directions and office layouts; directing to other departments and administrative services for further information, for example (but not limited to) Membership Services, Dental and Pharmacy.
• Handle ingoing and outgoing departmental mail and correspondence with patients.
• Other related duties as developed per department need.

Registration:

• Verify insurance eligibility and/or update all demographic information per regional policies, including Personal Provider Selection, Language Preference and Special Needs.
• Request and/or obtain a patient medical record number when necessary.
• Verify health insurance coverage and follow appropriate policy/procedure.
• Explain co-pays, cost shares and any other applicable fees.
• Create Guarantor accounts as necessary before and after Membership Service Department hours. Complete Scheduling form with above data and transfer to the Registration for completion of the pre-registration and pre-verification functions.
• Refers to the financial counselor as appropriate.
• Collect past due balances as appropriate.

Practice Organization:

• Coordinate referrals process including wait lists per department policies and procedures.

• Track referrals to specialty care by utilizing the consultation/referral system as needed in those areas where this responsibility currently exists for the individual in this classification.
• Request copies of films, CD's, test reports, and results from outside facilities.
• Coordinate schedules per department guidelines to maximize access.
• Collect and organize data per department guidelines. For example, researching and collating data from Health Connect, online quality and performance reports, MOV data, and other sources, on an ongoing basis.
• Develop and submit ongoing reports as requested including statistics, charts, and graphs using multiple computer programs and business math skills.
• Update departmental policies and forms.

Job Requirements:

• Customer service
• Multitasking
• Computer Skills
• Strong communication skills
• Critical thinking skills
• Excellent Customer services
• Must have previous call center experience at least 1 years
• Experience with HeatlhConnect a plus
• Ability to use multiple screens

At a minimum, a 7-year background check, education verification, employment verification, and drug screen will be conducted upon hire. Your suitability for employment is contingent upon successfully passing these required pre-employment screenings.

Don't miss out on this amazing opportunity! If you feel your experience is a match for this position please apply today and join our team. We look forward to working with you!

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

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