Summary
The Call Center Specialist is responsible for ensuring that all calls are answered in a timely fashion, with a pleasant attitude, providing high-level customer services to all patients and callers. Schedules medical patient visits, and answers call for dental and behavioral health. Obtains necessary data and insurance authorizations as appropriate.
Essential Duties and Responsibilities
Customer Care:

• Answers and directs calls with a pleasant voice in a timely manner
• Schedules patients in accordance with established provider schedules and clinic protocols
• Records no-shows and cancellations in system and patient records while routing patient messages to appropriate clinical staff
• Screens and provides information to patients on Sliding Fee Scale as appropriate
• Accurately captures patient demographics, insurance and structured data into the EHR system with each patient encounter
• Advises patients of clinic policies regarding scheduling, payments, no-shows, etc. and answers questions as appropriate, advises patients to bring in necessary financial and/or insurance documentation as indicated
• Monitors call volume alerts supervisor of changes
• Maintains strict patient confidentiality per HIPPA and company standards
• Ensure superior customer service to patients, including problem resolution
• Performs a variety of miscellaneous clerical tasks as time permits
• Performs other duties as directed, developed or assigned

Insurances:

• Performs an eligibility check on all medical visits for all sites including insurance and registration verification 3-days ahead of patient's visit
• Adjusts registration and insurance information accordingly in response to 3-day ahead check
• Contacts patients with terminated/ineligible insurance to notify them and share options to still be seen, including potential out of pocket cost
• Notifies frontline staff of eligibility issues before patient is seen to ensure proper payment/update of insurance is make before visit occurs
• Leaves detailed notes on appointment billing screen to translate eligibility to billing department
• Supports other departmental eligibility as needed as as time allows

Supervisory Responsibility: N/A
Qualification Requirements:

• High school diploma or equivalency
• Knowledge of standard office policies and procedures
• Experience working on computers; typing/keyboarding speed of at least 40 WPM
• Must have a positive attitude, be a team player, and be able to take directions from supervisor
• Understands and promote the mission, vision, and values of the health center both in the workplace and in the community
• Sensitivity to the needs and situation of multi-cultural population from a variety of income levels
• Ability to manage multiple tasks
• Excellent customer service skills and ability to effectively and respectfully handle dissatisfied patients
• Experience in a medical office setting/FQHC setting
• Responsible for extensive knowledge of programs/insurance & access/eligibility guidelines & applications (including Medi-Cal, CHDP, CPSP, Presumptive Eligibility, Family Pact, Sliding Scale)
• Must possess excellent organization, writing, and verbal skills
• English proficiency required; Spanish proficiency preferred
• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form

Equipment/Machinery: Fax machine, copier, personal computer, telephone, calculator, Microsoft Word/Excel, EHR system, and other software as required.
Physical Demands: The physical demands described here are representative of those that must be met by an individual to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Stand and walk or sit alternatively depending on specific needs of day. Estimate 20% of time is spent on feet and 80% sitting at desk.
• Have occasional need to perform the following physical activities: bend/stoop/squat, climb stairs, push or pull, reach above shoulders.
• Have occasional need to perform standing and walking activities.
• Constant need to perform the following physical activities: writing/typing, grasping/turning, finger dexterity.
• Lifting/carrying over 10 pounds occasionally. Lifting/carrying less than 10 pounds frequently.

Vision requirements: constant need to complete forms, read reports, view computer screen. Frequent need to see small detail. Frequent need to see things clearly beyond arm's reach.
Hearing requirements: constant need to communicate over telephone and in person.
Travel Requirements: Occasional need to utilize personal transportation to attend meetings or training.
Work Environment: The noise level in the work environment is usually moderate.