JOB SUMMARY

The Client Engagement Specialist, is responsible for answering high volume of telephone inquiries from patients and clients about available services at Care Resource, including Medical, Dental, Behavioral Health, and Case Management, following standard agency scripts and procedures. CES is responsible for ensuring clients (internal/external) always receives efficient and courteous customer service, in a constant strive to improve service delivery. Furthermore, the CES Team serves as a support unit of the Client Engagement Services department; consequently, equally responsible for the processing of insurance eligibility for all Care Resource patients prior to schedule appointments and whenever applicable based on need. The Client Engagement Specialist will organize patients appointments, schedule procedures, and coordinate office visits according to physicians and patient’s availability. Collect customers’ feedback and resolves customers’ issues quickly and effectively. The CES provides support to the medical, behavioral health departments and the PreP/PEP program to manage the flow of patients’ care for all 4 locations, by pulling medical records and identifying the patients’ needs to assist the best way possible. The CES identifies location and type of event to correctly schedule these appointments. Learning what other departments at Care Resource do and working with them on collaborative matters are concrete ways that a CES gains knowledge about the organization and works to better achieve its mission.

.JOB RESPONSIBILITIES

Patient/Client Services

Answers the telephone promptly in a courteous and professional manner according to health center guidelines for providing exceptional customer service.

Retrieves and returns dropped calls by listening to voicemails and provide the assistance needed. All queues’ inboxes should be cleared by the end of each workday.

Develops and maintains knowledge of all services offered and resources available at the health center.

Resolves routine general questions and/or issues/concerns presented by patients and customers via phone, by following established organization’s guidelines, scripts, and procedures. Moreover, the utilization of all available information/resources to resolve customer concerns/issues must always be standard practice.

Uses computer systems to log and track inquiries, as well as, to monitor the status of pending items in need of follow-up, such as medication refills, and/or further intervention additional parties.

Documents all customer interactions, including records details, complaints, comments, and actions taken.

Obtains and enters/updates accurate demographic information into the agency Practice Management and, including address, telephone numbers, insurance information, etc.

Uses EHR to verify pharmacy address, if referral is on file for patient to attend specialist appointment or if a lab order is on file to allow a lab appointment. Any information obtained should be to facilitate first call resolution avoiding the patient calling again for the same purpose and preventing unnecessary call transfer to another department.

Schedules patient/client appointments, including medical, behavioral, according to scheduling/color-coded templates, protocols/guidelines, credentialing grids, and PCP assignments.

Cancels or reschedules an appointment upon a patient’s request.

Provides guidance and proper instructions to patients regarding requested services.

Assists in the scheduling of interpreters for appointments requiring translation and/or sign language services.

Reviews, updates, and confirms appointment information with the caller, including appointment date, time, and location, as well as, provider name, reason for the visit, and insurance status, always and before ending every call.

Informs callers of necessary documentation needed on the day of appointment, including identification card, insurance card, proof of income (if applicable), medications, etc.

Answers questions in the most courteous, caring, and professional manner, as well as, to offer any additional information as requested, or needed.

CES conducts outbound calls to cancel, and/or reschedule patient medical appointments when the provider requests time off ahead of time, as well as, to provide additional assistance pertaining to accommodation of new appointments based on need. Scheduling appointments due to last-minute call-offs of providers will be handled by the medical Front Desk.

Directs calls to other departments as needed.

Documents the chart notes with clear guidance for the next person involved to understand previous actions taken.

Escalates calls appropriately according to procedures.

Maintains performance expectations including, but not limited to, Average Calls Answered, Average Handle Time (AHT), and other performance metric requirements.

Complies with HIPAA rules and regulations when communicating with patients, clients, health center personnel, and external vendors.

Makes sure, if needed, to verify all Commercial insurances, Medicare, Medicaid, and Ryan White for eligibility and benefits for future scheduled appointments, as well as, same day and walk-ins whenever applicable and based on need.

Ensures that FQHC patients have proof of income on file before scheduling an appointment.

Models Company culture of service standards in customer service, by providing gracious and efficient service with a sense of commitment, compassion, and competency to all our patients, as well as, to internal/external clients.

Culture of Service: 3 C’s

Compassion

Greets internal or external customer (i.e., patient, client, staff, vendor) with courtesy, making eye contact, responding with a proper tone and nonverbal language

Listens to internal or external customer (i.e., patient, client, staff, vendor) attentively, reassuring clients and providing appropriate options or resolutions

Competency

Provides services required by following established protocols and when needed, procures additional help to ensure appropriate services are delivered.

Commitment

Takes initiative and anticipates internal or external customer needs by engaging them in the process and following up as needed. Prioritizes internal or external customer (i.e., patient, client, staff, vendor) requests to ensure prompt and effective response is provided

Safety

Ensure proper hand washing according to Center for Disease Control and Prevention guidelines.

Understands and appropriately acts upon assigned role in Emergency Code System.

Understands and performs assigned role in health center’s Continuity of Operations Plan (COOP).

Other

Provides outstanding customer service to both internal and external customers using the Health Center’s 3C’s of service.

Participates in health center developmental activities as requested.

Other duties as assigned.

Training and Experience:

One to two years of experience in customer service, call centers, or receptionist/scheduling positions; specifically, in healthcare settings, are required. Training in HIV/AIDS preferred.

Job Knowledge and Skills:

Bilingual (English Spanish/ English-Creole) is required. Computer knowledge should include phone operating systems (Mitel), Word, Excel and Outlook. Knowledge of NextGen EHR. Proven excellent customer service skills, phone etiquette, and outstanding communication skills are required. Good organizational and teamwork skills are required. Ability to work with multicultural and diverse population is required.

Contact Responsibility:

The responsibility for internal and external contacts is frequent and important.

 PHYSICAL REQUIREMENTS

This work requires the following physical activities: frequent sitting, bending, standing, walking, talking in person and talking on the phone. Occasional driving, stretching/reaching and lifting to 50 lbs. are required. Work usually is performed in an office setting.