Call Center Representative

Brief Description
Lowell Community Health Center (Lowell CHC) is a community-based health care organization. Our programs have been recognized as national models. With a career at Lowell Community Health Center, you will be joining a dynamic team of passionate and talented people.
SUMMARY:
The Patient Access Representative (PAR) position serves as the primary contact for incoming calls for new and established patients and customers accessing or seeking information about Lowell CHC services. Pre-registers, schedules appointments and assists with overall patient requests. Works collaboratively with other members of the health center in order to provide superior patient care delivery. Projects a professional company image through phone interaction. The Patient Access Representative provides overall call and scheduling support to all of the health center departments.
RESPONSIBILITIES:
Essential duties and responsibilities include the following. Additional duties and responsibilities may be assigned as deemed necessary.
Call Center:
Answer phones in a professional and courteous manner and respond to patient/customer requests as appropriate.
Transfer calls or respond to requests accurately connecting patients to the correct department.
Assist in making reminder calls and following up with patients as needed regarding appointments.
Orient the patient about rights and responsibilities and overall health center services.
Registration Data Collection:
Accurately gather and input patient demographic, insurance, medical, and financial information into the practice management system.
Document patient consent and compliance.
Insurance Verification & Prior Authorization:
Enter and/or update all insurance information collected into the practice management system in a timely manner and with a high degree of accuracy.
Verify patient insurance coverage by navigating multiple systems to retrieve eligibility information.
Verify prior authorization and primary care provider assignment and help resolve issues to access.
Verify effective date and benefit information including primary care provider site, co-pays, and outstanding balances.
Work closely with the Health Benefits Navigators to act upon and resolve any issues involving patients who are uninsured or underinsured.
Address eligibility alerts, electronic actions and telephone encounters as corrections to patient accounts.
Contact patients whose insurances are inactive with advance notice to gather insurance information.
Appointment Scheduling:
Ensure accurate data entry in the electronic health record (EHR) system.
Schedule, reschedule, or cancel patient appointments as needed.
Provide information about appointment times and preparation requirements.
Collection Duties:
Inform patients of their co-pay, outstanding balance, or other patient responsibility due.
Educate patients on payment options, including cash pay, check, credit card, or online via MyChart.
Provide information about health insurance and financial assistance program options including sliding fee scale and refer patients to a Health Benefits Navigator if needed.
Promote, educate and sign up patients on the Patient Portal and respond to patient portal requests in a timely manner using department protocols.
Communication and Customer Service:
Use questioning and listening skills that support effective telephone communication.
Deliver exceptional customer service, creating a welcoming environment for patients. Resolve patient complaints and issues in a professional and timely manner.
Respect and maintain privacy and dignity of patients/customers and co-workers, while assuring patient/client confidentiality at all times.
Administrative Duties:
Maintain and update patient records in electronic health record (EHR) systems.
Manage patient intake forms, insurance eligibility checks, prior authorization, and other documentation.
Collaboration and Teamwork:
Work efficiently both individually and within a team to accomplish required tasks.
Assist in coordinating patient referrals to specialists or other departments.
Participate in department meetings and trainings as needed.
QUALIFICATIONS:
High school diploma or equivalent
Minimum of one year’s experience in a customer service-related position preferably in a health care setting
Data entry, computer, and phone skills are required
Proficiency in Microsoft Office and EHR systems is preferred
Able to work independently and with other members of a team
Effective communication and interpersonal skills
Must be able to remain calm and professional in a fast-paced environment
Ability to handle multiple tasks, solve problems, and work under pressure
Ability to work effectively in a high call volume environment
Bi-lingual language skills are highly preferred
WORK ENVIRONMENT:
Frequent contact with patients, families, visitors, nurses and other department staff. Occasional requests to change work areas to cover another priority area to meet patient needs. Occasional stress and pressure caused by multiple simultaneous demands. May be exposed to various infectious diseases. Universal precautions and techniques are included in orientation, and the availability of protective wear is supported and encouraged when the employee is at risk of exposure.