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Customer Care Representative I
Job Code:22-015-002
Campus/Location:Ortiz Campus
FT/PT Status:PT
Work Hours:8:00 AM - 5:00 PM
  

Job Responsibilities:
This is a highly responsible clerical position that requires a great deal of patient contact by phone or in person at the front desk. Must exercise independent judgment and demonstrate specific departmental knowledge as well as general agency knowledge. Customer Care Representatives will be assigned to central phone line responsibilities and front desk responsibilities on a rotating basis and based on daily staffing patterns. 
 
Central phone line specific responsibilities:

1. Serves as point of access for all inquiries and contacts, responding to all requests in a respectful, efficient and effective manner. 

2. Routes calls successfully, facilitating a warm hand-off whenever possible. 

3. Determines next step for customers seeking services (through a series of pre-determined questions.) 

4. Successfully registers new patients into the electronic health record.

5. Effectively verifies patient demographics and insurance and makes changes as needed and requested by patient.

6. Provides information related to community resources.

7. Links individuals to services as determined to be appropriate by scheduling appointment and/or making a referral via electronic medical record.  Communicates with program staff as needed to ensure successful linkage for each consumer.

Front desk specific responsibilities: 

1. Consistently serves as a friendly face to the patients that we serve by assisting with patient needs including, but not limited to checking in patients for appointments, updating demographics, verifying insurances and reliably directing and addressing patient questions and needs in a timely and accurate manner.

2. Successfully completes clerical/administrative duties in order to develop a consistent flow of patients and data in the SalusCare service delivery system. 

3. Effectively collaborates with the Outpatient leaders in discussing areas in need of improvement, by maintaining regular communication, making thoughtful recommendations, and follow through with assignments given.

4. Reliably assists Physician, APRN, RN, LPN, Therapists, Clinicians, managers, patients, collaterals, and other stakeholders as needed.

5. Effectively provides conflict resolution to both staff and individuals served.

6. Accurately checks patients out, scheduling follow-up appointments, if appropriate.

7. Effectively provides and explains the Release of Information Form and shares accurate information on the cost of copies.

8. Accurately revises and monitors the appointment schedule and ensures that appointments are scheduled within the guidelines established by the patient’s clinical level of need (emergent, urgent, routine), fund source, no show policy and agency procedures. 

9. Consistently collects co-payments and maintains an accurate cash drawer using proper cash handling procedures. Effectively assists in increasing collections by collecting fees, co-pays, and/or balances from each patient as they present.

10. Reliably on a daily basis submits reports and deposits.

11. Accurately resolves services, in conjunction with nursing staff, in a timely manner to allow for billing to be initiated.

General Customer Care Representative Responsibilities:

1. Customarily greets patients, both in person and by telephone, providing assistance utilizing excellent customer service skills.

2. Demonstrates excellent teamwork marked by mutual respect and collaboration.

3. Demonstrates proficiency and accuracy with the electronic health record.

4. Checks the answering service portal and completes follow up on messages within 1 business day. 

5. Routinely assists with satisfaction data collection via the patient satisfaction survey and other requested surveys.

6. Reliably checks voicemail at least twice daily (individual and group departmental) and returns all voice messages within 1 business day, and follows-up accordingly.

7. Reliably checks e-mail at least each hour daily and follows up on all needed actions within 1 business day and follows-up accordingly.

8. Actively coordinates with Billing Department relative to patient fees and payment plans.

9. Consistently maintains communication with the Billing Department, advising of all changes in insurance, per individual.

10. Accurately reviews fund source information and requests from outside insurers.

11. Reliably sends information to insurance companies, as needed following HIPAA procedures.

12. As staffing permits confirm appointments ahead of the scheduled visit and initiates no show calls within 1 day after the scheduled appointment, using the designated Patient Health Chart System as required by the department and location.

13. Satisfactorily collaborates with the on-site pharmacy to approve the Indigent Drug Program authorization as required by the program and location.

14. Customarily takes part in cross training with the support role of alternate department(s) as necessary/requested.  

15. Reliably presents at the assigned work location and is clocked in, ready for work and at their assigned work station on time.

16. Consistently serves as a resource for visitors seeking a staff person or location at one of our SalusCare campuses.

17. Satisfactorily keeps work area neat and organized.

18. Consistently maintains compliance with staff development training.

19. Routinely obtains additional training as requested/required independently by supervisor.

20. Continuously maintains compliance with confidentiality and HIPAA standards.

21. Regularly attends meetings as requested by supervisor.

22. Consistently displays cultural competence and sensitivity and ensures services provided incorporate patient-specific cultural values.

23. Routinely demonstrates a sound understanding of and commitment to complying with CARF standards of the Outpatient Services Department.

24. Successfully performs other related duties as assigned by supervisor.

Job Qualifications:
Requires a HS diploma or equivalent and at least one year of office/clerical work experience with frequent customer contact OR an Associate’s Degree with 6 months of successful work experience in any field. Must have excellent customer service skills, positive attitude, communication and organizational skills. Must be able to attain/maintain competency with agency electronic health record and use it effectively within required timeframes. Bilingual (English/Spanish) preferred.