PACT Representative I

Advocate Health and Hospitals Corporation • Kannapolis, NC

8h • Remote

About The Position

The PACT Representative I role is a full-time position within the Enterprise Corporate - Patient Access & Care department, focusing on the NC/GA Operations. This role is crucial in linking the patient experience between PACT and practice sites by utilizing facility/provider information, established policies, and critical thinking skills to assist inbound callers. The representative will also make outbound calls when necessary, perform basic technical troubleshooting for online applications and systems, and handle appointment scheduling, cancellations, and reschedules. A key aspect of the role involves obtaining and verifying demographic and insurance information, ensuring accuracy, and updating records according to government and third-party payer requirements. The position also requires identifying emergent calls, escalating them for immediate transfer to a Registered Nurse for triaging, and adhering to guidelines for emergency situations and critical call handling. The representative will determine patient needs, routing them for triage, scheduling, medication refill requests, and paging providers. Providing excellent customer service, as measured by post-call surveys, is essential. This includes asking clarifying questions, presenting options, understanding call complexity, and escalating only necessary situations. The role also supports organizational marketing efforts by providing information and referrals, maintaining databases, and conducting regular reporting. Maintaining knowledge and efficient utilization of all departmental information systems is also a responsibility. The position requires the incumbent to reside in AL, AK, AR, AZ, DE, FL, GA, IA, ID, IN, IL, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.

Requirements

• High School Graduate
• 0 -1 year experience in a call center, healthcare or other applicable customer service-related area
• 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 understanding of computers and desktop software packages.
• Ability to work in a fast-paced environment, handling a variety of customer/patient needs.
• Basic multitasking and problem-solving skills, as well as organization and prioritization skills.
• Ability to use/manage a multiple-line telephone system.
• 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.
• Ability to work with a variety of customers and actively listen to successfully determine the customer's needs.
• Ability to resolve customer issues.
• Ability to work a variety of hours based on departmental business needs.
• Must have functional vision, touch, speech, and hearing.
• Required to sit most of the workday.
• Operates all equipment necessary to perform the job.
• Must reside in AL, AK, AR, AZ, DE, FL, GA, IA, ID, IN, IL, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.

Nice To Haves

• Basic knowledge of medical terminology is helpful but not required.

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.
• 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 as requested to resolve issues.
• Schedules patient appointments and coordinates cancellations, reschedules, and additions to schedules.
• Obtains demographic and insurance information and verifies insurance coverage.
• Ensures insurance and patient information obtained is complete and accurate, updating information if necessary, applying acquired knowledge of government and third-party payer requirements.
• Completes all essential forms, obtains necessary information, such as patient demographic and insurance information.
• Verifies and updates the medical record with patient information.
• Identifies emergent calls based on information provided by caller and department procedures.
• Follows the process for immediate transfer to Registered Nurse for triaging.
• Responsible for competency in and adherence to guidelines for emergency situations and critical call handling.
• Determines the needs of patients calling the call center which results in routing patients for triage, scheduling, rescheduling, and 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 survey.
• Asks clarifying questions, presents options or solutions, and understands the level of complexity of the call, escalating only those situations necessary for resolution.
• Assists with organizational marketing efforts by providing associated information and referral to customer, while maintaining appropriate records for documentation.
• Conducts regular reporting and updating of the provider and marketing databases.
• Performs additional duties based on department needs.
• Maintains knowledge and efficient utilization of all information systems utilized by the department.

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

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