Telephonically enrolls, registers, and schedules appointments for primary care patients into The MetroHealth System (MHS). Processes prescription refill requests. Provides general telephone-based support to MyChart users. Obtains feedback for providers, and sends patient requests to clinics throughout MHS. Upholds the mission, vision, values, and customer service standards of The MetroHealth System.
Contributes to patient safety by supporting the System-wide programs and policies addressing a safe environment for patients and the reporting of safety concerns to the appropriate individuals.
1. Ensures accurate enrollment, registration, and appointment scheduling for patients into MHS by:
a. Issuing Medical Record Numbers to patients new to MHS.
b. Capturing complete demographic, insurance, and Guarantor information; entering that information into the appropriate system.
c. Obtaining appointment data, and communicating it back to the patient and/or referring provider.
2. Serves as a single contact point for referring physicians by:
a. Accurately processing refill requests from patients and patients’ pharmacy within 72 hours as needed based on call efficiency needs.
b. Obtaining clinical follow-up data as requested by referring providers.
c. Providing system navigation support to concierge clients, and acting as a liaison between MHS and patients’ insurers.
3. Works collaboratively with other service team members to resolve patient needs during the first call by:
a. Applying critical thinking to escalate urgent symptoms calls to team nurses for triage and medical advice.
b. Responding to all callers in a professional manner; escalating problem calls to the supervisor for resolution.
c. Collaborating with other team members for effective decision-making and problem-solving; seeking input from other team members as needed to address and resolve patient needs while on the first call.
4. Ensuring optimal reimbursement for medical services, and the efficiency of the referral process by:
a. Communicating with physicians, staff, insurance companies, and/or other departments to obtain additional necessary referral information as needed.
b. Relaying referrals/authorization information to patients/providers, securing authorization numbers, and entering this information into the correct information systems.
c. Monitoring appointment availability in MHS departments, and scheduling referral appointments.
d. Acting as a support system to other areas within MHS with questions about referrals and HMO insurance.
5. Meets all Service Delivery expectations, including:
a. Showing a customer-service orientation, with a focus on meeting the expectations of internal/external customers.
b. Utilizing positive customer relationship skills for all telephone encounters.
c. Supporting organizational change and/or changes in work flow processes or communication services.
d. Suggesting improvements and participating in organized efforts to improve service levels.
e. Handling multiple tasks effectively and efficiently.
f. Meeting service center benchmarks and/or quality indicators as monitored through audits or recordings.
g. Being available to patients by adhering to scheduled worktimes, phone status codes, and other expectations set by Network Service Center leadership.
h. Demonstrating flexibility in providing coverage for the call center in response to scheduling adjustments for unexpected team member absences, call center events, or call volume variances.
6. Completes additional responsibilities as needed based on the Network Service Center’s operational needs, including:
a. Cross-scheduling referral appointments as able, and/or obtaining appointments from departmental staff.
b. Ensuring that referrals are linked to scheduled visits.
c. Initiating outbound patient calls and follow-ups on primary care requests as needed based on coverage needs.
d. Processing patient MyChart requests, and providing desktop support to MyChart users.
e. Processing referrals from external providers and facilities.
f. Entering referral information in a timely manner using the correct information systems.
g. Educating community providers about the referral process as needed.
7. Keeps current with trends, developments, and practices in the field as they relate to this work assignment.
8. Incorporates principles of teamwork in the resolution, completion, and follow-up of responsibilities.
9. Performs other functionally related duties as assigned.
High School Diploma or passage of a high school equivalency exam.
Meets one of the following:
· 1 year of experience with any of the following: call center support, patient registration, scheduling, assisting health care professionals and patients, and/or utilizing phones and computers to perform customer service duties in a high-volume environment.
· In lieu of experience, an Associate’s degree in a healthcare or business-related field will be considered.
Customer-centric mentality with strong customer service experience.
Effective written, verbal, and interpersonal communication skills.
Ability to communicate with a variety of individuals and disciplines.
Solid organizational skills.
Ability to work independently and within a structured environment with a high degree of flexibility.
Demonstrated PC proficiency, including the ability to enter data into a PC while talking on the phone.
Fluency in writing, speaking, and interpreting both English and Spanish.
Proficient knowledge of medical terminology.
Knowledge of the Microsoft Office Suite of software, including Excel, Word, and PowerPoint.
Knowledge of EPIC.
Experience in sales.