Scheduling Customer Service Representative-PEH

Location Address: 1010 Spruce Street, Espanola, NM

Compensation Pay Range: Minimum $16.42 – Maximum $23.68

Position: Scheduling Customer Service Representative-PEH

Summary: Responsible for providing customer service for patients in regard to scheduling appointments, referrals, messaging, and maintaining patient demographics. Ensure callers receive service excellence through telephone, written, Pres Online, E‑Business, chat, and in‑person inquiries.

Type of Opportunity: Full time

Shift: Days

Responsibilities:

• Provide customer service for patients regarding triage, scheduling, referrals, messaging, and maintaining demographics.
• Respond to incoming calls routed through skill‑based technology to meet quality standards; conduct outbound calls as required and meet established quality/quantity guidelines supporting PHS/PHP/PMG initiatives.
• Develop and maintain positive customer or partner relationships; act as patient advocate with practitioners, employer groups, and brokers; promote customer satisfaction through timely responses and quality audit results.
• Assist in documentation of processes and procedures for functional improvements; use the Improvement model, identify patterns, conduct root‑cause analysis, and report to management.
• Research inquiries/special projects, respond to customers or partners, and ensure accuracy of benefit interpretation; use Microsoft Word, Excel, or similar databases.
• Participate as an effective team member in internal and process improvement teams.
• Record all interactions in appropriate databases for accurate data analysis and reporting.
• Assist in coordinating meetings for training, contracting, and reporting.
• Coordinate encounter or episode processes for customers/patients, including scheduling, registration, co‑pay collection, financial arrangements, charge posting, and reconciliation.

Qualifications:

• High school diploma plus 1–3 years office/business experience; call center experience preferred and/or claims processing experience in managed care.
• Demonstrated communication skills with members, employer groups, brokers, physicians, and office staff.
• Strong organizational skills and ability to create, sort, and analyze reports (Excel, Access).
• Knowledge of reimbursement methodologies (DRG, Relative Value Systems, Per Diem, Fee schedule, Capitation) and risk‑sharing programs.
• Some knowledge of CRM, EPIC, and other databases.
• Ability to function effectively as a team member and retain plan details and basic medical terminology.
• Ability to type 30 wpm with 90% accuracy.

Benefits: All eligible Presbyterian employees receive a comprehensive benefits package including medical, dental, vision, short‑term and long‑term disability, group term life insurance, and optional voluntary benefits.

AA/EOE/VET/DISABLED. PHS is a drug‑free and tobacco‑free employer with smoke‑free campuses.