Customer Service Representative

PURPOSE:

As a Customer Service Representative, you will be responsible for supporting the care of our patients in our Admin Offices. In this role you will answer patient inquiries, liaise between providers and patients, support authorizations for continued care, set follow up office visits, support and maintain provider schedules, obtain medication prior authorizations and more.

ACCOUNTABILITIES AND JOB ACTIVITIES:

Responsible for Patient Interactions & Coordination

• Manage incoming calls from patients
• Prioritizes & appropriately escalates triage calls
• Schedules patients as needed
• Communicates patient concerns as needed to adjacent departments
• Ensures follow up for moderate/high level concerns
• Obtains medication prior authorizations under clinician direction & patient insurance guidelines
• Communicates with staff and outside facilities (hospitals, physicians offices, labs, pharmacies, etc,) as needed
• Manage Medical Records Requests

Responsible for Carrying out Physician Orders

• Assists with troubleshooting patient calls related to post procedure concerns, prescription refills and pharmacy communication (not limited to calling prescriptions into the patient pharmacy)
• Obtains medication prior authorizations following provider direction and patient insurance guidelines

Clerical Functions/Responsibilities

• Documents communication between self, the patient and/or staff in a clear, concise manner that will allow those reviewing call notes easy interpretation
• As necessary, gathers faxed reports, reviews and contacts patient for appropriate follow up (immediate office visit (OV) versus routine OV)

Responsible for Documents & Medical Records

• Delegate faxes and other imported documents into patient chart when necessary

Safety and Dress Code Requirements

• Wear appropriate, business-casual attire to the admin office. (Examples: blouse, dress pants, jeans with no rips, cardigan, no shoulders showing, etc.)
• Uphold company COVID-19 policy and procedure if such a situation ever arises
• Maintain a safe environment for the employees and patients at all times

Develop and maintain personal and professional skills

• Attend all mandatory staff meetings per year unless excused as evidenced by documentation
• Actively participate in performance improvement activities as observed or documented
• Establish realistic professional goals as evidenced by the annual performance evaluation
• Actively keep abreast of departmental and organizational activities
• Demonstrate flexibility in response to unexpected change in workload or situations as observed
• Assist in the orientation of new personnel as directed
• Support the mission and goals of the company as observed
• Address all emails within 24 hours as documented
• Perform other duties as required

JOB REQUIREMENTS

COMPETENT LEVEL QUALIFICATIONS

MINIMUM LEVEL QUALIFICATIONS

SKILLS

(Typing and special machinery)

• Knowledge of Electronic Medical Record (eClinicalWorks)

• Good typing skills

• Good internet navigation skills

• Good customer service abilities

• General knowledge of insurances

• Knowledge of instrumentation used in office (fax, copy, computer)

• Knowledge of multi-line phone system

• Excellent Verbal and Written Communication skills

EDUCATION AND EXPERIENCE (Degrees, years in profession)

• 1+ years' admin or clinical experience in pain management

• 1+ years' experience obtaining prior authorizations for medications under the direction of a clinician

• High School Diploma equivalent or higher

Special Job Characteristics

• Fast paced work environment with established time constraints

• Must be comfortable with a high call volume

• Must be able to multitask while maintaining accuracy

• Must work well with others

OTHER REQUIREMENTS:

• Knowledge of common safety hazards and precautions to establish a safe work environment
• Must be able to act calmly and effectively in busy, stressful or emergency situations
• Ability to communicate effectively in person, by phone and in writing
• Require adherence to all policies and procedures, including standards for safety, attendance, punctuality and personal appearance
• This position must be willing to do any additional tasks as assigned by management