Call Center Representative-Patient Services

Presbyterian Healthcare Services

1d • $16 - $24 • Remote

About The Position

Presbyterian is hiring a skilled Call Center Representative to join our team. This role is a work at home position available for New Mexico residents only at this time. The Call Center Representative will be responsible for providing customer service for patients in regard to scheduling appointments, referrals, messaging, and maintaining patient demographics. They will ensure callers receive service excellence when responding to telephone, written, Pres Online, E-Business, chat, and in person inquiries.

Requirements

• High school/GED diploma
• 1 year office/business experience

Nice To Haves

• Call Center experience preferred.

Responsibilities

• Providing customer service for patients in regard to the triage of patients, scheduling appointments, referrals, messaging, and maintaining patient demographics.
• Responding to incoming calls routed through skill-based technology to meet quality standards and performance measurements.
• Being ready to take calls at the scheduled time, and spending the appropriate amount of time taking calls throughout their shift to resolve contacts on initial encounter.
• Conducting outbound calls as required and meeting established quality/quantity guidelines supporting PHS/PHP/PMG initiatives and/or programs.
• Developing and maintaining positive customer or partner relationships.
• Acting as member/patient advocate in dealing with practitioners, employer groups, and brokers.
• Maintaining prescribed standards of quality in all research, customer and partner contacts/service functions and promoting customer satisfaction/loyalty through quality contact and timeliness of responses, achieving quality audit results as required.
• Assisting in the development of documentation of process and procedures into functional process improvements to enhance overall level of service to our customers and partners.
• Using the Improvement model, identifying patterns in call inquiries/grievances, conducting root cause analysis in resubmitted and adjusted claims and reporting to management team.
• Researching inquiries/special projects as requested and responding to customer, partner or other PHS/PHP business units to ensure accuracy of benefit interpretation with results of research and resolution and within required timelines.
• Responding to customer or partners using Microsoft Word, Excel or similar databases when appropriate.
• Using available documentation such as D.A.R.T., Provider Manual, Pres Online, and Policies and Procedures to analyze and provide accurate and consistent information and benefit interpretation.
• Participating as an effective and active team member both individually and in a team environment.
• Participating in a value-added manner as a team member to internal teams as well as other process improvement teams (i.e. QCC) and initiatives.
• Recording all calls, mail, email, faxes, walk-in encounters, etc. in appropriate databases to provide meaningful, accurate data for analysis and reporting.
• Assisting in coordinating (when necessary) meetings with customers or partners for training, contracting, and reporting.
• Performing other functions as required.

Benefits

• Medical
• Dental
• Vision
• Short-term disability
• Long-term disability
• Group term life insurance
• Optional voluntary benefits
• Wellness rewards program (earn gift cards and more by participating in wellness activities like wellness challenges, webinars, preventive screenings, and more)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED