Access Care Representative; El Cajon La Maestra Community Health Center

Full time- $23.00 – $30.00 Hourly

Job Description

Status/ Hours
:
Full Time/ Non-Exempt

Pay Range:$23.00 to $30.00 per hour, Depends on Experience (DOE)

Location: El Cajon, CA

Summary:The Access Care Representative’s primary responsibility is to provide efficient and professional customer service to patients, providers, coworkers and other stakeholders via phone, email, messages, or other channels. This role involves answering inquiries, scheduling appointments, verifying information, and addressing concerns, all while maintaining confidentiality and adhering to healthcare regulations. The Access Care Representative is also responsible for verifying eligibility for every patient prior to scheduling to determine coverage.

Customer service is a core competency for Access Care Representatives.

• The Access Care Representative will greet and handle inquiries and appointments via telephone in a prompt and timely manner.
• Addressing customer questions regarding appointments, billing, insurance, programs and other healthcare-related topics.
• Scheduling, rescheduling, and confirming appointments based on patients’ needs and urgency.
• Verifying Information:
  Gathering and verifying patient demographic and insurance details.
• Maintain effective communication and working relationships with other employees, departments and patients.
• Maintain attention to detail with every call, in order to schedule accurately while following the patient’s PCP and Care teams.
• Addressing Complaints:
  Handling patient complaints and concerns professionally and empathetically.
• Documentation:
  Maintaining accurate records of patient interactions and inquiries.
• HIPAA Compliance:
  Ensuring adherence to HIPAA regulations to protect patient privacy.
• System Proficiency:
  Utilizing call center software, electronic health records (PM & EHR), Phreesia and other relevant systems.
• Communication
  
  Skills:
  
  Providing clear and concise information to patients, manager and other stakeholders.

• Maintain effective communication skills with patients. This includes listening skillfully and displaying a willingness and ability to acknowledge patient needs, expectations and values through the use of reflective listening and empathy conveyance. Responds to patient needs in a way that is helpful and beyond expectation.
• Answer telephones (includes scheduling appointments) and provide information on Clinic operations following La Maestra’s established Phone Call Etiquette.
• Schedule appointments using the PCMH script.
• Assign patients to a Primary Care Provider (see PSR Procedures and Protocols).
• Always maintain La Maestra’s Phone Call Etiquette (see PSR procedures and Protocols).

• When asking patients whether their visit is an emergency room follow-up, the ACR must:
  • Ask whether their appointment is an ER follow up without the patient having to do so.
  • Inform the patient that their physician WILL NOT be able to give them the proper appointment without their emergency room records therefore the patient needs to be assisted by a Case Manager first to retrieve the records. The process for getting the emergency room records is lengthy, resulting in an elongated wait time.

• Check emails and department messages and take appropriate action (i.e. call back patient, schedule appointment, forwarding message information to intended recipient, etc.).
• Responsible for being familiar with the basic guidelines and standards of the government programs the Clinic is engaged in and patients’ use, in paying for services. Become and remain familiar with common private insurance company basic guidelines and standards.
• Maintain office supplies and reorder as necessary.
• Other functions as directed by the Supervisor.
• Follow up on the no show patients (the day appointment was missed).
• Appointment Confirmations:
  Call patients to remind them of scheduled appointment, check in time, and what they need to bring. (1 or 2 day prior to the appointment, this based on department).
• Responsible for assisting patients with linkages to clinic services and other community-based services as needed.
• One third of receptionists’ performance includes patient satisfaction levels. Performance Appraisal will include the level of…