Patient Services Representative - Valencia, United States - Tri Source International

Description

Company Background

TSI is one of the fastest-growing outsourcing companies worldwide with Contact Center operations throughout the US, Mexico, and Latin America and world headquarters in Valencia, CA.

We are disrupting the world of outsourcing and benefit from our leadership position in an industry experiencing strong year-over-year growth.

Company Culture & Mission

TSI makes outsourcing simple so that our clients can focus on their core business and drive sales growth. TSI is the sales, customer service, and back-office support engine behind many top brands, products, and services.

We are very selective with the partners with whom we engage as well as the teammates we invite to be a part of our family.

This keeps us focused on our Values:
Transparency, Transparency, Passion, Balance, Results, People and Fun

Job Summary

Our state-of-the-art Contact Center is looking to build on our biggest strength: our teammates We are searching for professional and compassionate patient services representatives with GREAT communication skills.

Must have strong time management, willingness to learn, and a desire to have FUN at work.

Our client is a humanitarian, not-for-profit organization that provides comprehensive primary care and community health services for people living in their area.

They strive to improve health equity and reduce health disparities with high quality, accessible, and compassionate care delivered in their Health Centers, community settings, and patient homes.

You would be a great fit for our team if you can combine superior listening and communication skills with a passion for helping people.

We provide in-depth training and a pathway to success

Job


Responsibilities:

Our patient services representatives are responsible for answering incoming calls from providers, health plans, and members as they relate to appointments, eligibility, benefits, claims, coverage, and authorization of services.

This position will also problem-solve and explain programs and procedures to callers and will answer/address claim payment questions with providers.

Must be Bilingual in Spanish/English.


Responsibilities include:

• Consistently use a professional, courteous approach to facilitate communication with patients, providers, and thirdparty intermediaries.
• Conducts client registration interviews. Collects or confirms all necessary demographic, insurance, health, and financial information from customers at registration accurately entering it into the ESS.
• Schedules appointments and records reasons for visits on the patient notes in the scheduling software system.
• Informs patients of any preparation or special requirements for their appointments
• Provides travel directions to patients when necessary.
• Verifies coverage and benefits through the online process for each appointment.
• Identifies clinical and financial criteria that require the involvement of the case management team or Benefits Specialist.
• Resolves clinical scheduling conflicts to accommodate the needs of all involved parties
• Confirms patient's payment sources utilizing online systems; accurately interprets financial cues; provides patient with payment plan information or consults with a Team Lead, Universal Benefits Specialist, or Coordinator as needed.
• Responsible for explaining the Health Center fee schedule to all clients and collection of fees based upon client income.
• Identifies deductibles, copayments, and outstanding balances according to policy communicating the amounts due to the patient and the payment expectations.
• Maintains annual goals for registration accuracy, call release status, call handle time, and average department call answer time.
• Translates or obtains language line assistance for clients and staff as requested.
• Follows established guidelines for the use and/or disclosure of protected health information. Employees should report any breaches of the Health Insurance Portability and Accountability Act (HIPAA) rules to the Privacy Officer (AVP of Quality, Education & Risk Management) immediately. Failure to comply with HIPAA policies and procedures will result in disciplinary action, up to and including termination of employment.

Requirements:

• 13 years of customer service experience in a call center and/or health care environment
• AS degree or equivalent work experience in a medical office or hospital in a similar role
• Superior listening skills
• Must be able to work in sitting position, use computer and answer telephone
• A strong sense of responsibility for providing a great customer experience
• Detailoriented and highlyorganized
• Excellent verbal and written communication skills.
• Ability to handle multiple tasks and prioritize work
• Knowledge of basic computer skills, especially Microsoft Office Suite
• Ability to alphabetize and add/subtract/multiply and divide as necessary
• Bilingual in Spanish/English as follows: Speaking-Required, Reading-Preferred, Written-Preferred

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