PACT Representative I

Advocate Health and Hospitals Corporation • Winston Salem, NC

15h • Hybrid

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 responsible for linking the patient experience between PACT and practice sites by utilizing facility/provider information and established policies. The representative will assist inbound callers, make outbound calls when necessary, and escalate complex issues for resolution. A key part of the role involves performing basic technical troubleshooting for online applications, systems, and access issues. Responsibilities also include scheduling patient appointments, coordinating cancellations and reschedules, obtaining and verifying demographic and insurance information, and ensuring accuracy of patient records. The representative must identify emergent calls and follow procedures for immediate transfer to a Registered Nurse for triaging, adhering to guidelines for emergency situations and critical call handling. They will determine patient needs, routing them for triage, scheduling, medication refill requests, and paging providers. Providing excellent customer service according to departmental standards, asking clarifying questions, presenting options, and escalating only necessary situations are crucial. The role also involves assisting with organizational marketing efforts, maintaining databases, and performing additional duties as needed. Maintaining knowledge and efficient utilization of all departmental information systems is essential.

Requirements

• High School Graduate
• Typically requires 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 knowledge of medical terminology is helpful but not required.
• 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.

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.
• Has the ability to recognize 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.
• Responsibilities include scheduling patient appointments and coordinating 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
• medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• 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