Patient Representative I

About the Role

Department: Enterprise Corporate - Patient Access & Care

Team: Support Services

Status: Full-time

Hours Per Week: 40

Schedule: Monday-Friday 8am-5pm, Work holidays

Pay Range: $21.85 - $32.80

Key Responsibilities

• Uses facility/provider information and established policies and procedures to seamlessly link the patient experience between PACT and the practice site.
• Uses resources and critical thinking skills to assist inbound callers, and makes outbound calls when required or when follow-up is deemed necessary.
• Recognizes complex problems and questions and escalates for resolution when needed.
• Performs basic technical troubleshooting in connection to online applications, systems, or access to resolve issues.
• Schedules patient appointments and coordinates cancellations, reschedules, and additions to schedules.
• Obtains demographic and insurance information and verifies insurance coverage, ensuring accuracy and updating information as necessary, applying acquired knowledge of government and third-party payer requirements.
• Completes all essential forms, obtains necessary information (e.g., patient demographic and insurance information), and verifies/updates the medical record with patient information.
• Identifies emergent calls based on information provided by caller and department procedures, and follows the process for immediate transfer to a Registered Nurse for triaging.
• Demonstrates competency in and adherence to guidelines for emergency situations and critical call handling.
• Determines patient needs calling the call center, resulting in routing for triage, scheduling, rescheduling, canceling appointments, submitting medication refill requests for evaluation, and paging providers and facilities as appropriate.
• Provides customer service per established departmental standards as measured by patients on post-call surveys.
• Asks clarifying questions, presents options or solutions, and understands call complexity, escalating only necessary situations for resolution.
• Assists with organizational marketing efforts by providing associated information and referrals, while maintaining appropriate records for documentation.
• Conducts regular reporting and updating of provider and marketing databases.
• Performs additional duties based on department needs.
• Maintains knowledge and efficient utilization of all information systems utilized by the department.

Requirements & Tech Stack

• Call center or other applicable customer service-related area experience.
• High School Graduate
• Ability to work in a fast-paced environment.
• Ability to manage a multiple-line telephone system.
• Ability to work with a variety of customers/patients and actively listen to determine needs.
• Ability to resolve customer issues.
• Ability to work a variety of hours based on departmental business needs.
• Functional vision, touch, speech, and hearing.
• Required to sit most of the workday.
• Operates all equipment necessary to perform the job.
• Exposed to normal office environment and/or remote work environments.

Qualifications

• Knowledge of customer service and ability to work with a variety of patients and patient situations.
• Ability to follow workflows while operating in a structured environment.
• Basic knowledge of medical terminology is helpful but not required.
• Basic understanding of computers and desktop software packages.
• Basic multitasking and problem-solving skills.
• Organization and prioritization skills.
• Demonstrated ability for analysis, logical thinking, accuracy, and concern for detail.
• Strong verbal communication skills and ability to interact with a diverse customer population.
• Ability to provide excellent customer service and follow-up.
• Ability to communicate with customers/patients while researching and documenting the interaction on multiple systems.