Overview:
Tekwissen Group is a workforce management provider throughout the USA and many other countries in the world. This client is a locally based, nonprofit healthcare organization. Their health system includes two hospitals, a 100-provider primary and specialty care medical group, a cancer center; and a new medical fitness center.
Job Title: Call Center Pt. Servc. Rep., Primary Care Location: Fairfield, CA, 94534 Duration: 3 Months Job Type: Contract to Hire Work Type: Onsite JOB SUMMARY: Duties: - The Call Center Patient Services Representative performs general office duties including appointment scheduling, determining and verifying insurance eligibility, and processing of detailed messages to physicians.
- The Patient Services Representative functions as part of a clerical, clinical, and customer service team in support of primary care practices.,
Skills: - Registration and Charge Entry
- Gathers, updates and verifies a comprehensive package of registration and insurance/payer information and ensures accurate entry into the practice management system.
- Provides information to patients regarding the selection process for a primary care physician, assists in determining insurance eligibility, co-payments, share of costs and other financial responsibilities for services rendered.
- Verifies and documents eligibility for all payers.
- Reviews benefit plan/s with patient to determine specific allowances and/or restrictions based on services requested.
- Researches and answers inquiries related to claims, eligibility and referrals.
- Ensures the accuracy of demographic and insurance information in accordance with the policies, procedures and service expectations of each department.
- Maintains professional standards by actively participating in committees, inservices and QI activities and standards development.
- Acts as a resource to new and existing staff in personal areas of subject matter expertise.
- Presents a professional demeanor in appearance and attitude.
- Floats to other areas as needed.
- Performs other duties as assigned.
Appointments and Reception: - Obtains complete demographic information for new patients ensuring accurate entry into the practice management system. Confirms/updates demographic information for existing patients.
- Confirms eligibility/PCP assignment status for patients with WHA, Health Net or Solano Partnership insurance prior to scheduling appointment.
- Demonstrates effective listening skills to determine appropriate call routing.
- Schedules appointments on the phone in accordance with approved provider protocols and current scheduling policies, procedures and algorithms.
- Monitors provider schedules to ensure appointments are booked for correct type and correct time allocation.
- Places confirmation or rescheduling calls in accordance with scripted guidelines and current policy and procedures.
- Assists in physician schedule maintenance functions including coordination of physician absences with open appointment times.
- Gathers data and performs provider access audits.
Medical Records: - Adheres to System policies related to confidentiality of medical record information, transcription and copies or distribution of medical record content.
- Handles patient documents appropriately to ensure patient confidentiality.
Education: - High School Graduate or equivalent preferred. Some college business or computer course work essential.
Licensure/Certification: - AHA BLS certification required within 60 days of hire. Course work in medical terminology preferred
Experience: - 1-2 years working in a healthcare environment required.
- 6 months of direct client Call Center training/experience can be substituted for healthcare experience.
- 1-2 years direct experience working in a call center environment preferred.
- Strong experience in insurance verification preferred.
- Strong communication skills and dynamic customer service experience preferred.
Skills: - Strong organizational and written and spoken communication skills essential.
- Demonstrated mastery of practice management systems is required with CPT, ICD9 coding experience beneficial.
Experience in the following areas preferred: - appointment scheduling, registration process, insurance verification, primary care preventive care.
- Demonstrated ability to work independently on a variety of complex tasks, managing competing deadlines.
- Bilingual capability preferred.
Interpersonal Skills/Customer Service: - Demonstrates the client Way.
- The client Way is a set of value-based behaviours that are to be consistently demonstrated and role modeled by all employees that work at client.
- The client Way principles consist of Caring, Communication, Collaboration, and Competence.
Hours: Physical Effort: - The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Walking, some bending, stooping, and lifting.
- Position requires extensive use of computer keyboarding throughout the day.
TekWissen Group is an equal opportunity employer supporting workforce diversity.