Patient Care Representative

OneVeracity•Kennesaw, GA

66d•Onsite

About The Position

The Patient Care Representative communicates with healthcare professionals to obtain prescription information, works with patients to determine and coordinate individual prescription needs, and collaborates with team members to resolve issues involving patient orders. The role provides customer service in an onsite call center, handling member inquiries about plan benefits and offering accurate information and personalized solutions. Representatives document calls, protect confidential information, coordinate with internal departments and external providers, and keep current with benefit, policy, and claim-processing changes. They are expected to meet department standards for quality, production, and attendance and to communicate with empathy and clarity.

Requirements

General PC knowledge, including Microsoft Office.
Excellent customer service, communication, organizational, and interpersonal skills.
Attention to detail, accurate reporting, and follow-up.
Analytical and problem-solving skills.
Proficiency in processing and entering prescriptions.
Ability to work in teams and coordinate efforts to complete work assignments on time.
Ability to sit for extended periods and use a computer for a significant portion of the day.
Ability to communicate effectively in person, by phone, and by email.
Manual dexterity for keyboarding, phone calls, and handling paperwork.
Ability to read printed and digital materials and to hear and comprehend conversations and discussions clearly.

Responsibilities

Communicate with healthcare professionals to obtain prescription information.
Determine and coordinate individual prescription needs with patients.
Work with team members to resolve issues relating to patient orders.
Provide exceptional customer service in an onsite call center by analyzing situations, navigating multiple computer systems, and applying conflict-resolution skills.
Respond to member inquiries about plan benefits with accurate information and personalized solutions; maintain organized resources and refer members to community services when appropriate.
Protect member privacy and data security by following HIPAA guidelines and company confidentiality policies.
Use technology and software to document calls from members, providers, and other customers clearly and accurately.
Collaborate with and relay information to appropriate departments and partners through approved company channels and procedures.
Contact physicians, hospitals, pharmacies, and other providers as needed to answer questions and obtain or provide information.
Review and become familiar with new or revised benefits, policy information, and claim-processing procedures.
Meet department standards and expectations, including quality, production, and attendance.
Explain complex information clearly and concisely, tailoring explanations to support member understanding.
Listen actively, show empathy, ask thoughtful questions, address concerns, and help members feel heard and supported.
Perform additional duties as assigned.