Medicare Call Center Jobs (NOW HIRING)

JOB SUMMARY

HealthRIGHT 360, a nonprofit organization and a family of programs, is committed to providing accessible and comprehensive healthcare services to vulnerable populations. Our mission is to tackle systemic barriers to healthcare and promote health equity for all. We offer a wide range of services, including mental health care, residential and outpatient substance use treatment, and primary health services. Additionally, we provide transitional support for individuals re-entering the community after involvement in the criminal justice system. By integrating physical and behavioral health, we empower individuals to overcome challenges by addressing social determinants of health, fostering resilience, and facilitating recovery.

The Call Center is a comprehensive initiative designed to streamline customer communication, enhance service quality, and improve operational efficiency across all inbound and outbound call interactions. The department focuses on delivering timely, accurate, and empathetic customer support while leveraging technology and analytics to drive performance and satisfaction.

The Call Center Agent provides excellent customer service to both external and internal clients. This position answers high volume of calls, schedules medical, dental, and behavioral health appointments, provide support to clinic, directs phone inquiries to appropriate departments, and provides program information to all callers.

KEY RESPONSIBILITIES 

Incoming calls

• Answers a high volume of calls and schedules appointments for all patients with a high degree of accuracy.
• Knowledgeable of primary medical care, behavioral, and dental services to provide accurate information to all callers.
• Maintains average call time and as indicated in call center guidelines.
• Maintains average call volume as indicated in call center guidelines. Monitors incoming calls and works with Call Center Manager to minimize abandoned call rates.
• Knowledgeable about insurances and funding programs, such as MediCal, Medicare, Healthy San Francisco, Family PACT, and commercial insurances.
• Communicates sliding fee scale policies to patients appropriately.
• Communicates clearly on the phone and accurately documents and assigns messages and faxes.
• Confirms and updates contact information for all patients at every contact.

Outgoing calls

• Make follow-up calls for any messages left. Completes robust confirmation calls for all next-day appointments.
• Robust confirmation calls include confirming reason for visit, necessity of visit, appointment time, appointment provider, verification of insurance, notification of any co-pays, deductibles, share of costs, or payments due, and any paperwork that may be needed to be completed.
• Assist with scheduling changes by contacting patients to reschedule appointments.

Documentation Responsibilities

• Accurately documents and promptly updates required patient information in electronic health record system.
• Documents billing notes and general medical appointment reminders on the appointment screen, as well as on the patient information screens.
• Collects and verifies contact information at every call.
• Enters patient insurance information for patients and verifies eligibility with patients.
• Documents appointment visit status, including rescheduled, cancelled, confirmed, left voice message, or any other status appropriately.

Productivity Responsibilities:

• All calls must be answered within 3 minutes.
• Must be able to answer a minimum of 1500 calls (based on the number of staff and total number of calls) per month.

Customer Service

• All communications, both internal and external, must be delivered with excellent customer service.
• Must be courteous and professional for all patient interactions.
• Must talk to patients and clients in a caring and non-judgmental manner.
• Must be able to deliver care in a culturally and linguistic sensitive manner.
• Must ensure to use patient’s preferred name and pronouns.
• Must adhere to scripted phrases, welcoming patients and thanking them for their phone calls.
• Listens and documents patient complaints, and routs calls to appropriate staff for swift resolution.

And perform other duties as assigned. 

QUALIFICATIONS

Education, Certification, and Experience  

• High school diploma or GED.
• 2 years’ experience working in a medical setting (or call center), preferably in a community clinic with medical experience is preferred.
• Familiarity with other community agencies in the Bay Area to make appropriate referrals.
• Prior experience in front desk reception, administrative and/or customer service.
• Experience working with staff and volunteers.

Knowledge and Skills

• Knowledge of computerized medical scheduling and billing systems.
• Knowledge of HIPAA regulations.
• Excellent attention to detail, ability to work independently and strong organizational skills.
• Commitment to working with diverse communities, including communities of color, homelessness, and users of illegal substances, HIV/AIDS patients and persons with mental health concerns.
• Strong organizational, interpersonal, listening, speaking and written communication skills.
• Ability to work effectively with all levels and types of employees, management, clients and guests.
• Ability to work cooperatively and effectively as part of a team.
• Ability to multi-task and work well independently and under pressure in a fast-paced environment; detail-oriented.
• Strong proficiency with Microsoft Office applications (Excel, Outlook and Word), specifically Word Outlook and internet applications.
• Understanding of harm reduction philosophy and ability to provide non-judgmental, client-centered services.