Scheduling Customer Service Representative

Presbyterian Healthcare Services; Espanola (NM); Presencial; USD 23 000 - 36 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

Voluntary benefits

Resumo da oferta

Presbyterian Healthcare Services in Espanola, NM is seeking a Scheduling Customer Service Representative to assist patients with appointments, referrals, messaging, and demographics. The role involves handling calls, Pres Online, and in-person inquiries to deliver service excellence.

Responsibilities include triage, scheduling, data maintenance, and accurate benefit interpretation using standard procedures, with a high school diploma and 1–3 years office or call-center experience desired.

Qualificações

• High school diploma plus 1–3 years office/business experience; call center experience preferred.
• Strong communication skills in person and by phone with members, employer groups, brokers, physicians, staff.
• Excellent written communication and business writing/presentation skills.
• Strong organizational skills; ability to create, sort and analyze reports (Excel, Access) and manage processes.
• Knowledge of reimbursement methodologies (DRG, RVU, Per Diem, Fee schedules, Capitation); risk-sharing knowledge helpful.
• Knowledge of CRM and EPIC and other Enterprise databases.

Responsabilidades

• Triage patients, schedule appointments, handle referrals, messaging, and maintain demographics.
• Respond to calls routed through skill-based tech; meet quality standards and timely responses.
• Build and maintain relationships with patients, practitioners, employers, and brokers; promote satisfaction and loyalty.
• Assist in documenting processes and improving service; analyze call patterns and root causes.
• Research inquiries using Word/Excel and available docs to provide accurate benefit interpretations within timelines.
• Record all interactions in databases to support analysis and reporting.
• Coordinate meetings with customers/partners for training, contracts, and reporting.
• Manage encounter flow including scheduling, registration, co-pays, finances, and reconciliation.

Conhecimentos

Customer service

Communication

Organization

Typing 30 wpm

Formação académica

High school diploma

Ferramentas

Excel

Access

CRM

EPIC

Descrição da oferta de emprego

Location Address

1010 Spruce StreetEspanola, NM 87532-2724

Compensation Pay Range

Minimum Offer $16.42 Maximum Offer $26.10

Now Hiring: Scheduling Customer Service Representative

Summary

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

Type of Opportunity: Full time
Job Exempt: No
Job is based: Presbyterian Espanola Hospital
Work Shift: Days (United States of America)

Responsibilities

• Responsible for providing customer service for patients in regard to the triage of patients, scheduling appointments, referrals, messaging, and maintaining patient demographics.
• Respond to incoming calls routed through skill-based technology to meet quality standards and performance measurements. Is ready to take calls at the scheduled time, and spends the appropriate amount of time taking calls throughout their shift to resolve contacts on initial encounter. Conducts outbound calls as required and meets established quality/quantity guidelines supporting PHS/PHP/PMG initiatives and/or programs.
• Develop and maintain positive customer or partner relationships. Acts as member/patient advocate in dealing with practitioners, employer groups, and brokers. Maintains prescribed standards of quality in all research, customer and partner contacts/service functions and promotes customer satisfaction/loyalty through quality contact and timeliness of responses, achieves quality audit results as required.
• Assists in the development of documentation of process and procedures into functional process improvements to enhance overall level of service to our customers and partners. Uses the Improvement model, identifies patterns in call inquiries/grievances, conducts root cause analysis in resubmitted and adjusted claims and reports to management team.
• Researches inquiries/special projects as requested and responds to customer, partner or other PHS/PHP business units to ensure accuracy of benefit interpretation with results of research and resolution and within required timelines. Responses to customer or partners to be done using Microsoft Word, Excel or similar databases when appropriate. Uses available documentation such as D.A.R.T., Provider Manual, Pres Online, and Policies and Procedures to analyze and provide accurate and consistent information and benefit interpretation.
• Participates as an effective and active team member both individually and in a team environment. Participates in a value-added manner as a team member to internal teams as well as other process improvement teams (i.e. QCC) and initiatives.
• Record all calls, mail, email, faxes, walk-in encounters, etc. in appropriate databases to provide meaningful, accurate data for analysis and reporting.
• Assist in coordinating (when necessary) meetings with customers or partners for training, contracting, and reporting.
• Coordinates the encounter or episode process for the customer/patient including scheduling, registration, co-pay collection, financial arrangements, charge posting, and reconciliation of monies collected.

Qualifications

• High school diploma plus one to three years office/business experience, call center experience preferred and/or claims processing experience preferably in managed care with possible enrollment experience
• Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, physician office staff.
• Written communication skills as well as business writing and presentation skills are required.
• Requires strong organizational skills, ability to create, sort and analyze reports (Excel, Access, etc) and system processes.
• A thorough knowledge of reimbursement methodologies i.e. DRG, Relative Value Systems, Per Diem, Fee schedule, Capitation, etc and some knowledge of risk sharing programs helpful.
• Some knowledge of CRM and EPIC as well as any other databases that may be used PHS Enterprise wide.
• Demonstrated ability to function effectively as a team member. Requires ability to retain plan details and basic medical terminology. Must be able to work cooperatively with other employees and function under pressure. Demonstrated ability to sustain quality standards. Ability to type 30 wpm with 90% accuracy.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness

Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

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