Call Center Representative II

Kuresmart; Annapolis, Northern (MD, KY); Hybrid; USD 28,000 - 30,000; Full time

Benefits offered by this job

Health benefits

401(k) with employer match

Up to 96 PTO hours in first year

Job summary

Kuresmart in Annapolis, MD, is seeking a CCR II to manage referral processing and appointment scheduling using an omni-channel approach. You will gather patient demographics, verify insurance, and maintain medical records while coordinating with patients, physicians, and insurers.

The role requires HIPAA awareness, strong communication, and solid organizational skills. This is an on-site position with opportunities to grow within the call center team.

Qualifications

• High School Diploma or equivalent required
• 1 year of related experience and/or training
• Knowledge of Internet and MS Office; experience with a CRM like Salesforce or Dynamics 365
• Excellent written and oral communication skills
• Ability to work independently and in a team
• Multi-tasking and prioritization
• Strong attention to detail and organization
• Understand medical terminology and basic practices
• Meet predefined production and quality standards
• Ability to manage and direct others
• Desire to provide strong customer service compliance with regulations

Responsibilities

• Process referrals accurately within CRM systems
• Schedule appointments for referred patients via omni-channel contact (phone, email, text)
• Obtain patient demographics and insurance information
• Coordinate with physicians, attorneys, insurers and other stakeholders
• Maintain patient records and verify insurance eligibility in real time
• Ensure first call resolution and escalate as needed
• Keep up-to-date knowledge of services and policies
• Participate in trainings and meet company standards
• Perform other administrative duties as assigned

Skills

Communication skills

Teamwork

Multitasking

Organization

Attention to detail

Problem solving

Education

High School Diploma or equivalent

Tools

Salesforce

Microsoft Dynamics 365

MS Office

Job description

Under the direction of call center management, provides customer service utilizing an omni-channel approach, including phone calls, emails, and text messaging to ensure seamless coordination and timely scheduling of appointments for referred patients. The CCR II's primary responsibility involves processing referrals within the CRM system, reaching out to patients to schedule appointments promptly and appropriately. Responsible for obtaining patient demographics, insurance information, and medical histories. Duties include a high degree of patient, physician and both internal and external stakeholder interaction; utilization of patient information; coordination of insurance documentation; creation of patient medical records; reading medical records for verification; and maintenance of practice schedules. This position requires exceptional professionalism, customer service, and organizational skills to effectively manage referral processing and appointment scheduling tasks.

Essential Duties and Responsibilities:

• Performs job in accordance with Company mission, vision and goal.
• Exercises confidentiality in all areas, abiding by HIPAA rules and regulations.
• Processes incoming referrals efficiently and accurately within the designated timeframe.
• Utilizes CRM software to manage and update patient information and referral status.
• Provides professional and courteous customer/patient care, displaying knowledge of the treatment approach; displayed through professional phone etiquette.
• Accurately collects all required new patient information, including complete and accurate insurance data and verifies eligibility in real-time.
• Employs persuasive communication techniques in an omni-channel approach to encourage patients to schedule appointments promptly and actively schedule appointments with patients for applicable medical services.
• Professionally communicates with attorneys, adjusters, insurance companies, and other relevant parties regarding legal patients involved in motor vehicle accidents (MVA), workers' compensation cases, personal injury claims, etc.
• Collaborate with internal teams and external stakeholders to ensure seamless coordination and resolution of all patient cases, including legal cases.
• Checks messages, as directed, and relays responses from the provider to the patient.
• Accurately describes, in detail, the reason for the patient call in the task.
• Expedites service in situations requiring urgent attention, as determined by management.
• Efficiently utilizes available resources to accurately and efficiently process necessary flows.
• Ensures first call resolution for all applicable calls. Escalates/routes appropriate calls/tasks to proper recipient(s) for resolution.
• Maintains high level of product and service knowledge.
• Maintains minimum quality standards, as determined by the Company.
• Communicates electronically with patients/customers via online portal or other Company communication methods.
• Assists with various administrative duties.
• Checks work e-mail on a regular basis throughout the workday.
• Participate in and complete all required trainings and in-services.
• Other duties as assigned.

Minimum Qualifications:

• High School Diploma, or equivalent
• One (1) year of related experience and/or training.
• To perform this job successfully, an individual should have knowledge of Internet and Microsoft Office software (MS Word, MS Excel, MS PowerPoint, MS Outlook) and experience working with a CRM platform such as Salesforce or Microsoft Dynamics 365
• Must have excellent written and oral communication skills.
• Must be able to work individually as well as within a team.
• Must be able to multi-task and prioritize.
• Must demonstrate extreme attention to detail.
• Must possess strong organization skills.
• Must be able to perform calculations, problem solve and use reasoning.
• Must have knowledge of medical practices and medical terminology.
• Must be able to meet predefined production and quality standards.
• Must be able to effectively manage and direct others.
• All staff are expected to have a strong desire to provide excellent customer service; to comply with the rules and regulations of those organizations to which we are accountable; to have high ethical and professional standards of conduct; and to have an attitude of wanting to continuously improve their own professional performance.

Preferred Qualifications:

• One (1) year of prior experience working with an Electronic Medical Record (EMR).
• One (1) year of high quality customer service experience, preferably in a healthcare setting.
• Previous experience working with client relationships and stakeholders, particularly in communicating with attorneys, adjusters, providers, and insurance companies.
• Familiarity with basic medical and legal terminology and documentation related to motor vehicle accidents, workers compensation, personal injury claims, etc.

Driving/Travel:

The employee must have reliable transportation. While the primary workplace may be closest to the employee’s home, work assignments could be in any of the Company’s locations.

Compensation and Benefits:

• Pay Range: $20.00/hr - $22.00/hr
• PTO: Up to 96 hours in first year (pro-rated based on start date)
• Holidays: 7 (New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, Day After Thanksgiving, Christmas Day)
• Retirement: 401(k) with employer match
• Health Benefits: Medical (single and family), Dental (single and family), Vision (single and family)
• Other Company-Paid Benefits: Short-Term Disability, Long-Term Disability, Basic Life/AD&D, Employee Assistance Program
• Other Voluntary Benefits: Voluntary Life, Accident, Critical Illness, Hospital Indemnity
• Other Compensation: This position is non-exempt (hourly) and eligible for overtime pay in accordance with applicable law. Overtime is not guaranteed. This position is not eligible for bonus, commission, incentive, or shift differential pay.