Client Service Representative - Miami, United States - Care Resource

Description

** Client Service Representative**

**Job Category****:** Grants & Development **Requisition Number****:** CLIEN01216 Showing 1 location **Job Details**

**Description**

The Client Service Representative, CSR, is responsible for answering high volume of telephone inquiries from patients and clients about the available services at the Health Center, including Medical, Dental, Behavioral Health, and Case Management, following standard agency scripts and procedures. CSR is responsible for ensuring clients (internal/external) receive efficient and courteous customer service at all times, in a constant strive to improve service delivery. Furthermore, the CSR Team serves as a support unit of the Call Center; consequently, equally responsible for the processing of insurance eligibility for all Care Resource patients prior to scheduled appointments and whenever applicable based on need.

**Essential Job Responsibilities**

**Patient/Client Services**

Answers the telephone promptly in a courteous and professional manner according to health center guidelines for providing exceptional customer service.

Models Company culture of service standards in customer service, by providing gracious and efficient service with a sense of commitment, compassion and competency to all our patients, as well as, to internal/external clients.

Develops and maintains knowledge of all services offered and resources available at the health center.

Retrieves and responds all voice messages in a timely manner (within 24 hours).

Enters tasks and accesses the patient portal to email questions/requests and solutions within the same time frame.

Resolves routine general questions and/or issues/concerns presented by patients and customers via phone, by following established organizations guidelines, scripts, and procedures. Moreover, the utilization of all available information/resources to resolve customer concerns/issues must always be standard practice.

Uses computer systems to log and track inquiries, as well as, to monitor the status of pending items in need of follow-up and/or further intervention additional parties.

Accounts and documents all customer/payer interactions, including records details, complaints, comments, and actions taken.

Obtains and enters/updates accurate demographic information into the agency EHR/Practice management system, including address, telephone numbers, insurance information, etc.

Schedules patient/client appointments, including medical, behavioral, and dental, according to scheduling/templates, protocols/guidelines, credentialing grids, and PCP assignments.

Assists in the scheduling of interpreters for appointments requiring translation and/or sign language services.

Reviews, updates, and confirms appointment information with the caller, including appointment date, time, and location, as well as, provider name, reason for the visit, and insurance status, at all times and before tending every call.

Informs callers of necessary documentation needed at the day of appointment, including identification card, insurance card, proof of income (if applicable), medications, office visit fees, etc.

Answers questions in the most courteous, caring, and professional manner, as well as, to offer any additional information as requested, or needed.

CSR will conduct outbound calls to cancel, and/or reschedule patient medical, behavioral, and dental appointments, as well as, to provide additional assistance pertaining to accommodation of new appointments based on need.

Performs outbound calls to follow up on no shows appointments, as well as, to attempt to reschedule accordingly based on need and availability.

Directs calls to other departments as needed.

Escalates calls appropriately according to procedures.

Maintains performance expectations including, but not limited to, Average Calls Answered, Average Handle Time (AHT), and other performance metric requirements.

Complies with HIPAA rules and regulations when communicating with patients, clients, health center personnel, and external vendors.

Makes sure, if needed, to verify all Commercial insurances, Medicare, Medicaid, and Ryan White for eligibility and benefits for future scheduled appointments, as well as, same day and walk-ins whenever applicable and based on need.

**Culture of Service: 3 Cs**

**Compassion**

Greets internal or external customers (i.e. patient, client, staff, vendor) with courtesy, making eye contact, responding with a proper tone and nonverbal language.

Listens to the internal or external customer (i.e. patient, client, staff, vendor) attentively, reassuring and understanding of the request and providing appropriate options or resolutions.

**Competency**

Provides services required by following established protocols and when needed, procure additional help to answer questions to ensure appropriate services are delivered

**Commitment**

Takes initiative and anticipates internal or external customer needs by engaging them in the process and following up as needed

Prioritize internal or external customer (i.e. patient, client, staff, vendor) requests to ensure the prompt and effective response is provided

**Safety**

Ensures proper hand washing according to the Centers for Disease Control and Prevention guidelines.

Understands and appropriately acts upon the assigned role in Emergency Code System.

Understands and performs assigned roles in the organizations Continuity of Operations Plan (COOP).

**Contact Responsibility:**

The responsibility for internal and external contacts is frequent and important.

**Physical Requirements:**

This work requires the following physical activities: frequent sitting, bending, standing, walking, talking in person and talking on the phone. Occasional driving, stretching/reaching and lifting up to 50 lbs. are required. Work usually is performed in an office setting.

**Other**

Participates in health center developmental activities as requested.

Other duties as assigned.

**Interpersonal Skills** *Expert* **Dedicated****:** Devoted to a task or purpose with loyalty or integrity **Goal Completion****:** Inspired to perform well by the completion of tasks **Flexibility****:** Inspired to perform well when granted the ability to set your own schedule and goals **Ability to Make an Impact****:** Inspired to perform well by the ability to contribute to the success of a project or the organization **Education**

**Required**

High School or better.

**Experience**

**Required**

**2 years:** One to two years of experience in customer service, call centers, or receptionist/scheduling positions; specifically in healthcare settings, are required. Trainings in HIV/AIDS preferred.