Patient Access Navigator in San Pedro Garza García at Pediatric Associates

PRIMARY FUNCTION

Provide world-class service by answering incoming patient calls across multiple regions, assisting with scheduling, registration, insurance verification, and general inquiries. This role ensures accurate documentation, supports high call-volume environments, and delivers a warm, professional patient experience while following established protocols and maintaining performance standards.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This list may not include all the duties that may be assigned.

1) Answer incoming patient calls with a professional, friendly, and upbeat attitude; respond to patient concerns and inquiries with accuracy and empathy, aiming for one-call resolution whenever possible.

2) Follow approved scripts and protocols based on call type to ensure consistency and quality.

3) Register new patients, verify insurance and personal information in compliance with HIPAA, and gather all necessary details to support timely and accurate physician follow-up.

4) Schedule patient appointments, identify future visit needs, and process referral requests for provider approval.

5) Accurately document all interactions, clinician messages, questions, and patient information in XPM, CRM, and EHR systems; maintain and update customer databases.

6) Research required information using available resources and communicate with office staff as needed to support patient care and clinician follow-up.

7) Participate in ongoing training and meetings to stay current on protocol changes; learn multiple regional processes and flexibly support different regions based on call-volume needs.

8) Meet all established performance standards, including maintaining a minimum CSAT score of 4.5/5 and at least 90% schedule adherence.

QUALIFICATIONS

EDUCATION:

• High School diploma or equivalent.

EXPERIENCE:

• Minimum of two years of experience in a call center environment required; four years preferred.
• Previous experience in a healthcare or scheduling environment preferred.
• Experience working in high call volume environments with 85%+ occupancy

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge of XPM/EHR and Contact Recorder preferred.
• Familiarity with automated call distribution, IVR, and skill-based routing systems.
• Ability to pass an English proficiency assessment with an overall score of at least 8.0 (B2) and a minimum score of 8.7 (C1) in the speaking section. Overall score of C1 English proficiency, with C2 proficiency in speaking section preferred.
• Flexible availability within our hours of operation, with the understanding that we will provide as much notice as we can for any schedule adjustments.
• Ability to manage high call volumes.
• Comfortable working in a fast paced, constantly evolving environment.
• Familiarity with automated call distribution, IVR, and skill-based routing systems.
• Excellent communication and listening skills.
• Ability to meet performance targets based and follow action plans when required.
• Strong commitment to delivering an outstanding patient experience.
• Ability to communicate professionally while maintaining a friendly and warm tone.
• Accurate data-entry skills with strong attention to detail.
• Resilience to handle upset patients while remaining calm, supportive, and solution-focused.
• Demonstrated ability to work effectively in a team environment.
• Strong multi-tasking abilities.
• High level of accuracy, attention to detail and timeliness.
• General PC proficiency, including Microsoft Office, internet navigation, and email.
• Proficiency in PowerPoint required.

TYPICAL WORKING CONDITIONS

• Non-patient facing
• Must be MX based.
• Working in a professional office environment.
• The position involves high & frequent call volumes.
• Environment requires ability to multi-task, communicate clearly & concise, data entry for extended period of times.
• Will require sitting for long periods of time.

OTHER PHYSICAL REQUIREMENTS

• Vision
• Sense of sound
• Sense of touch

PERFORMANCE REQUIREMENTS

Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI (Protected Health Information) in accordance with organizational policy, Federal, State, and local regulations.