Representative,PCC Operations

PRIMARY FUNCTION:
Answer incoming calls from patients to provide outstanding customer service in support of the mission, goals, and values.

ESSENTIAL FUNCTIONS OF THE JOB:

• Answer incoming calls by welcoming patients with a professional, upbeat, friendly attitude.
• Follow prepared scripts based on call type.
• Register new patients by gathering pertinent information and entering into OP and ECW system.
• Verify insurance coverage and information.
• Set patient appointments upon request and identify future visits.
• Document accurately and efficiently within all systems (OP and ECW).
• Document all questions and messages for Clinicians and label them properly using the telephone communication access protocol.
• Data entry and maintenance of customer databases.
• Properly obtain and confirm patients/caller information abiding by HIPAA law.
• Collect all necessary and pertinent information over the phone to facilitate timely and accurate physician follow-up.
• Complete any necessary referrals requested by telephone contact for provider approval.
• Provide customers with product and service information.
• Respond to patient inquiries.
• Research required information using available resources.
• Communicate with offices when necessary.
• Handle customer complaints and other customer support-related issues, and provide customers with proper solutions.
• Meet established standards within all performance criteria.
• Attend any necessary training/meetings to be up to date on protocol changes and available training.
• Other duties may include, but are not limited to, outbound calls, copying, faxing, etc.

ADDITIONAL FUNCTIONS FOR CLINICAL AGENTS:

• Provide medical guidance via telephone using the telephone communication access protocol, clinical triage algorithms, and clinical judgment.
• Document all medical advice given over the phone.
• Schedule appointments using clinical prioritizing protocols and scheduling policies.
• LPNs and Registered Nurses answer calls and questions from Patient Contact Center Representatives and have the ability to triage high acuity patients.

TYPICAL

WORKING CONDITIONS:

Working in a professional office environment. The position involves high and frequent call volumes. Environment requires the ability to multitask, communicate clearly and concisely, and data entry for extended periods of time. Will require sitting for long periods.

PERFORMANCE REQUIREMENTS:

Adhere to all organizational information security policies and protect all sensitive information, including but not limited to ePHI and PHI, in accordance with organizational policy, Federal, State, and local regulations.

EDUCATION AND LICENSURE:

• High School diploma or equivalent.
• Representatives that are performing as Clinical Agents require at least one of the following licensures or certificates: MA diploma or certificate, LPN, or Registered Nurse.

EXPERIENCE AND SKILLS:

• Prefer minimum of one year experience in a call center environment.
• Knowledge of XPM and CRM system desired.
• Familiar with automated call distribution, IVR, and skill-based routing systems.
• Previous customer service experience required.
• Strong verbal, written, and interpersonal communication skills.
• Experience with coaching and mentoring employees.
• Demonstrates ability to work well in a team environment.
• Strong multitasking skills.
• Attention to detail, accuracy, and timeliness are critical.
• General PC knowledge including Microsoft Office, Internet, and Email.
• Needs to be proficient in PowerPoint.

COMPENSATION AND BENEFITS:

The expected base hourly range for this position located in Upland, CA is $21.00 to $27.52. Pediatric Associates offers are based on several factors, including but not limited to the candidate’s education, work experience, and certifications, all of which are dependent on the requirements of the specific role. In addition to base salary, Pediatric Associates offers a comprehensive benefits package, potential incentive and recognition programs, and retirement planning (all benefits are subject to eligibility requirements based on position and division).