Service Center Representative

POSITION DESCRIPTION:

Serves as a first point of contact for customers by phone, as well as a liaison between external customers and medical staff. Answers incoming calls, assesses the urgency of the call, appropriately triages and directs all calls according to established procedures to ensure optimal quality patient care. Schedules patient appointments, communicates and coordinates scheduling with clinical personnel to optimize patient care and efficiency. Provides a high level of customer service to all internal and external customers.

ESSENTIAL JOB FUNCTIONS:

1. Answers incoming calls, assesses the urgency of the call, appropriately triages and directs all calls according to established procedures to ensure optimal patient care; schedules appointments by protocol, communicates and coordinates scheduling with clinical personnel to optimize patient care and efficiency.
2. Obtains necessary patient registration information, verifies patient insurance eligibility, prepares charts for visits in accordance with IHA protocols and notifies clinical staff of patient’s arrival, if applicable.
3. Answers telephone in accordance with IHA telephone etiquette guidelines, taking and relaying messages in a timely manner.
4. Schedules and confirms patient appointments; obtains appropriate information, enters preliminary account data into computer and confirms appointments based on office protocols.
5. May collect payment(s) and ensures timely and accurate posting of payment.
6. Records messages for physician and staff accurately, with complete information required, and ensures that it is routed appropriately through Trinity Health IHA Medical Group EMR system.
7. Assists patients with MyChart-related questions. Keeps current on updates, changes and FAQ’s.
8. Accurately documents into IHA systems.
9. Maintains familiarity with physician office, Billing Department and all extended care location basic services and hours of operation to respond to customer requests accurately and promptly.
10. Assists patients and facilities with questions related to referrals, authorizations and requisitions per established protocols.
11. Accurately completes patient forms.
12. Supports report management and patient outreach. May support overdue report management.
13. Supports other offices, attends meetings and training as assigned.
14. Performs other duties as assigned.

ORGANIZATIONAL EXPECTATIONS:

1. Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the mission and values of both IHA and Trinity Health.
2. Must be able to work effectively as a member of the Service Center team.
3. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
4. Successfully completes IHA’s “Our Experience” training and adheres to IHA’s standard of promptly providing a high level of service and respect to internal or external customers.
5. Maintains knowledge of and complies with IHA standards, policies and procedures.
6. Maintains complete knowledge of office services and in the use of all relevant office equipment, computer and manual systems.
7. Maintains strict patient and employee confidentiality in compliance with IHA and HIPAA guidelines.
8. Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respects cultural differences.
9. Uses resources efficiently.
10. If applicable, responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.

MEASURED BY:

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS:

EDUCATION: High School Diploma or GED. Course work in insurance/billing, medical practice education or seminars are all preferred.

CREDENTIALS/LICENSURE: None

MINIMUM EXPERIENCE: Previous experience in a combination of patient services, medical reception, call/customer service center (medical environment) or other customer service environment.

POSITION REQUIREMENTS (ABILITIES & SKILLS):

1. Knowledge of virtual PPSC protocols, processes and procedures related to position responsibilities.
2. Excellent written (legible), verbal and face-to-face communication skills, including proper phone etiquette.
3. Proficient/knowledgeable in-patient care procedures and organizational policies related to position responsibilities.
4. Service-oriented; responsive to customer needs and courteous in approach.
5. Ability to monitor, organize and keep work area neat.
6. Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, Microsoft Word /Excel/Outlook, intranet and computer navigation.
7. Ability to compute mathematical calculations.
8. Sufficient knowledge of medical terminology, billing, insurance, referrals and authorizations to perform responsibilities.
9. Ability to work collaboratively in a team-oriented environment; displays professional and friendly demeanor.
10. Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, patients, family members, vendors, outside customers and couriers.
11. Good organizational and time management skills to effectively juggle multiple priorities and time constraints.
12. Ability to exercise sound judgement and problem-solving skills, specifically as it relates to resolving or escalating difficult or complex issues to appropriate areas as needed.
13. Ability to handle patient and organizational information in a confidential manner.
14. Ability to travel to other office/practice sites and meeting and training locations.
15. Successful completion of IHA competency-based program within introductory and training period.

MINIMUM PHYSICAL EXPECTATIONS:

1. Physical activity that often requires keyboarding, filing and phone work.
2. Physical activity that often requires extensive time working on a computer.
3. Physical activity that sometimes requires walking, standing, bending, stooping, reaching, and/or twisting.
4. Physical activity that sometimes requires lifting, pushing and/or pulling under 30 lbs.
5. Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus.
6. Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.
7. Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.

MINIMUM ENVIRONMENTAL EXPECTATIONS:

This job operates in a typical call center/office environment which involves frequent interruptions and significant interaction with people which can be stressful at times.