Call Center Representative

Description

Call Center Representative

It is our goal to provide the finest Orthopaedic care possible. This philosophy requires that all office staff and providers be sensitive and responsive to patients’ needs and preferences. To ensure that we hire and retain the quality of staff needed for implementing our philosophy of service, we have adopted the following job description for this position. A strong commitment to exceptional customer service is essential to this role.

Every patient interaction should be handled with professionalism, empathy, respect, and a desire to provide a positive experience while meeting the patient’s needs. The position is an hourly position. Workdays are typically scheduled withing a five-day workweek. Hours and days may vary based on operational needs. All scheduling complies with applicable California wage-and-hour-laws.

Many of the responsibilities require that you have a working knowledge of computers and the ability to make proper use of the programs utilized in this office, or those that may be necessary to meet the needs of the practice.

Under the supervision of the Call Center Manager, the Call Center Representative serves as the primary point of contact for patients and plays a key role in supporting access to care and efficient clinic operations. This position is responsible for providing professional, patient-centered service by assisting callers, coordinating communication between patients and healthcare teams, and facilitating access to services. The ideal candidate demonstrates strong customer service, organizational, and communication skills, with the ability to effectively manage multiple tasks in a fast-paced healthcare environment while maintaining confidentiality and professionalism.

The Call Center Representative performs a variety of administrative and patient service functions, including answering incoming telephone calls, scheduling and coordinating patient appointments, updating patient demographic and insurance information, and verifying insurance eligibility. Responsibilities include obtaining prior authorizations, reviewing patient documentation to support accurate scheduling, scanning and routing documents to patient records, and creating action messages for appropriate members of the care team.

The position also promotes patient engagement through the use of patient portal and digital communication tools, maintains departmental productivity and quality standards, and ensures compliance with organizational policies, HIPAA regulations, and established workflows and procedures.

• Answer incoming telephone calls promptly and professionally.
• Obtain and update patient demographic information, including insurance coverage, copayments due at the time of service, to ensure accurate registration.
• Verify patient insurance eligibility using available verification tools and online resources.
• Obtain prior authorizations and required documentation through insurance portals, primary care providers, or other appropriate sources.
• Schedule, reschedule, cancel, and confirm patient appointments according to established scheduling guidelines.
• Review clinic notes and patient documentation to ensure accurate appointment scheduling.
• Scan and route patient documents to patient’s chart.
• Create and route action messages to the appropriate members of the patient care team, including MA’s, Providers, Treatment Processors, and other departments as needed.
• Obtain email addresses to web/text enable patients while educating the patients about the Patient Portal and promote digital communication.
• Maintain productivity and performance metrics established by the department.
• Follow departmental workflows, policies,…