Clinical Contact Center Specialty Representative

Kaiser Permanente•Central City, CO

About The Position

Schedule and document for a variety of routine to complex medical visits/procedures for members/patients via inbound and outbound calls for Surgical and Medical Subspecialties as assigned. Transfer calls or message appropriate personnel/departments according to protocol. Asks patients exam-appropriate screening questions and documents information. Instruct and inform preparations, nature of examinations, reporting procedures, and other pertinent information to the member/patient within scope outlined and defined by department policy and guidelines. Provides scheduling decisions, which improve and maximize overall system efficiencies and increase appropriate utilization. Responsible for scheduling procedures including Preop evaluations and anesthesia for Gastroenterology OR slot/procedures as needed. Order prescriptions and other tests that pertain to scheduling that are required and approved by the physician/provider. Serves as a resource to internal and external customers for CT, MRI, and Nuclear Medicine information services. Consults with physicians, providers, designated health plan staff, and members/patients to coordinate outside referrals. Departments could include Endo, Interventional Radiology, Plastic Surgery, Rehab Services, Rheumatology, Urology, Wound Care, Vascular, General Surgery, Allergy, Pulmonology, Sleep Medicine, Head and Neck, Dermatology, Neurology, Orthopedics, Gastroenterology, Cardiology, Neurosurgery, Optometry, Ophthalmology, Radiology, and other subspecialities. Makes members/patients and their needs a primary focus of ones actions; develops and sustains productive member/patient relationships. Essential Responsibilities: This position, knows and complies with all Kaiser Permanente quality, safety, and emergency policies and procedures. Demonstrates quality and effectiveness in work habits and clinical practice in every interaction with patients, colleagues, providers, and leadership. Ensures patient safety in the preparation and provisioning of care related to but not limited to medications, procedures, infection prevention, fall prevention, including consistent use of two patient identifiers and procedural time outs. Reports safety hazards, accidents and incidents, and unsafe working conditions promptly. Appoints routine to complex schedules for multiple specialties. Acts as a liaison via inbound/outbound calls between Kaiser Permanente members/patients, Care Delivery teams, internal and external physicians/providers, and anesthesiologists, to coordinate care as needed. Makes complex scheduling decisions that maximize efficiency and utilization according to established guidelines. Schedules, for the entire region, CT, MRI, Nuclear Medicine, Mammography, Sonography, Fluoroscopy, Bone Mineral Densitometry, and Diagnostic Imaging examinations for Health Plan members, with the members themselves and with multi-disciplinary providers. Determines the probable length of the procedure. Coordinates the availability of the Technician, room and camera, and Radiologist availability with the availability and need of the patient. Schedules required/approved anesthesia for procedures per physician/provider direction. Schedules Pre-op evaluations in the Preop Evaluation Education Center (PEEC) or Primary Care. Schedules biopsies and coordinates schedule with recovery, pathology, the nurse, and radiologist. Schedules myelograms and arthrograms and coordinates back-to-back times for fluoroscopy and CT. Reviews the member/patient care history in appropriate Kaiser system. Order prescriptions and other tests that pertain to specialty scheduling that are required and approved by the physician/provider. Must be able to adapt and process new information daily as events arise and system changes are implemented that change approved booking procedures. Relays approved messages, test results, and patient care information per guidelines to members/patients within Scope of Employment (SOE). Messages information or transfers calls to appropriate personnel if member/patient requests advice, an urgent/emergent appointment or according to established protocol. Gather information from the patient /provider regarding possible surgeries, medication, medical devices in place, or other conditions that could affect scheduling of appointment. Conduct chart review for optimal scheduling of appointment. Educate and inform patients on the appropriate preparation as to what to do and what to avoid, the type of clothing to wear and possible side effects. Provides information/resources for laboratory services within Kaiser Permanente and at our partner institutions. Provides co-pay information to the patients based on their selected benefit plan. Schedules interpreter for non-English speaking members or members that are hearing impaired. Documents third-Party Liability, Workmans Compensation, and Auto Accident procedures/requirements related to identification for the specialty appointment scheduling and billing process. May reschedule appointments and contact member/patient based on supervisor request. Utilizes web-based application to receive instructions from the Radiologists regarding recommendations and need for scheduling additional exams for patients; and to document actions and final resolution status. Confers and consults with physicians, providers, designated health plan staff (i.e.. nurses, radiology liaisons and technologists), and members/patients to coordinate outside referrals. Initiate outside referrals for CT, MRI and Nuclear Medicine. Determines when it is appropriate to refer out and assigns the appropriate vendor. May utilize chat function as a day-to-day resource. May coordinate scheduling of one or more back-to-back appointments with two or more departments. Serves as a liaison between the Radiology Department and all departments and providers requesting CT, MRI, and Nuclear Medicine examinations. Remains informed on new technologies and their implications for patients and the Radiology Department. Maintains proficiency in the use of the Radiology Information System, Health Connect, CMS, and current telephone techniques.

Requirements

Minimum of two (2) years of experience scheduling physicians/providers in a healthcare setting required.
Minimum of one (1) year previous experience in managing high volume of inbound and outbound calls is required.
Per the National Agreement, current KP Coalition employees have this experience requirement waived.
High School Diploma OR General Education Diploma (GED) required.
Successful completion of basic medical terminology course or experience using medical terminology.
Previous experience using a computer terminal required.
Must pass typing test of 35 WPM with 5% or less error rate.
Ability to work effectively with providers, patients, support staff and other personnel to coordinate schedules which requires a high degree of accuracy and attention to detail.
Proficient user of computer systems.
Excellent customer service skills required.
Effective verbal, written, interpersonal and problem-solving skills essential.
Demonstrated customer focus abilities and the ability to understand Kaiser Permanente customer needs.

Nice To Haves

Working knowledge of surgery scheduling computer applications.
Online appointment scheduling or completion of training course highly preferred.
Minimum of one (1) year of college level courses preferred.

Responsibilities

Appoints routine to complex schedules for multiple specialties.
Acts as a liaison via inbound/outbound calls between Kaiser Permanente members/patients, Care Delivery teams, internal and external physicians/providers, and anesthesiologists, to coordinate care as needed.
Makes complex scheduling decisions that maximize efficiency and utilization according to established guidelines.
Schedules, for the entire region, CT, MRI, Nuclear Medicine, Mammography, Sonography, Fluoroscopy, Bone Mineral Densitometry, and Diagnostic Imaging examinations for Health Plan members, with the members themselves and with multi-disciplinary providers.
Determines the probable length of the procedure.
Coordinates the availability of the Technician, room and camera, and Radiologist availability with the availability and need of the patient.
Schedules required/approved anesthesia for procedures per physician/provider direction.
Schedules Pre-op evaluations in the Preop Evaluation Education Center (PEEC) or Primary Care.
Schedules biopsies and coordinates schedule with recovery, pathology, the nurse, and radiologist.
Schedules myelograms and arthrograms and coordinates back-to-back times for fluoroscopy and CT.
Reviews the member/patient care history in appropriate Kaiser system.
Order prescriptions and other tests that pertain to specialty scheduling that are required and approved by the physician/provider.
Relays approved messages, test results, and patient care information per guidelines to members/patients within Scope of Employment (SOE).
Messages information or transfers calls to appropriate personnel if member/patient requests advice, an urgent/emergent appointment or according to established protocol.
Gather information from the patient /provider regarding possible surgeries, medication, medical devices in place, or other conditions that could affect scheduling of appointment.
Conduct chart review for optimal scheduling of appointment.
Educate and inform patients on the appropriate preparation as to what to do and what to avoid, the type of clothing to wear and possible side effects.
Provides information/resources for laboratory services within Kaiser Permanente and at our partner institutions.
Provides co-pay information to the patients based on their selected benefit plan.
Schedules interpreter for non-English speaking members or members that are hearing impaired.
Documents third-Party Liability, Workmans Compensation, and Auto Accident procedures/requirements related to identification for the specialty appointment scheduling and billing process.
May reschedule appointments and contact member/patient based on supervisor request.
Utilizes web-based application to receive instructions from the Radiologists regarding recommendations and need for scheduling additional exams for patients; and to document actions and final resolution status.
Confers and consults with physicians, providers, designated health plan staff (i.e.. nurses, radiology liaisons and technologists), and members/patients to coordinate outside referrals.
Initiate outside referrals for CT, MRI and Nuclear Medicine.
Determines when it is appropriate to refer out and assigns the appropriate vendor.
May utilize chat function as a day-to-day resource.
May coordinate scheduling of one or more back-to-back appointments with two or more departments.
Serves as a liaison between the Radiology Department and all departments and providers requesting CT, MRI, and Nuclear Medicine examinations.
Remains informed on new technologies and their implications for patients and the Radiology Department.
Maintains proficiency in the use of the Radiology Information System, Health Connect, CMS, and current telephone techniques.