On Call Medical Insurance Call Center Jobs in Riverside, CA

Description

Call Center Representative (Appointment Scheduler)

 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.

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.

BASIC FUNCTION: 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.

RESPONSIBILITIES: 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.

General Clerical Activities (There may be other duties required of this position not listed below):

• 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, procedures, and quality standards.
• Provide a high level of customer service while demonstrating professional telephone etiquette and effective communication.
• Maintain patient confidentiality and comply with all HIPAA and organizational privacy requirements.
• Perform other duties and responsibilities as assigned by the Call Center Manager.

RELATIONSHIPS: The Call Center Representative (Schedulers) should observe and conduct the following relationships:

1. The employee shall be responsible directly to the Call Center Manager. The employee shall report to the Call Center Manager and his/her assignees any progress, reports, requests, concerns, problems, and/or expectations in relation to the responsibilities of the position. Such communication may be verbal or written as deemed necessary by the employee or as directed by the Call Center Manager or his/her assignee.
2. The employee shall interact with other office and clinical staff in the Practice. Such interactions should be collegial, professional, and contributing to the safety and pleasantness of the work environment at Arrowhead Orthopaedics.
3. The employee shall interact with patients, medical groups, adjustors, nurse case managers, hospitals, and Primary Care Physicians and their offices. Such communication should always reflect the total commitment of the office to quality care and customer satisfaction. All communication should be professional and any unresolved conflicts are to be reported to the Call Center Manager.

This job description in no way states or implies that these are the only duties to be performed by this employee. The Call Center Representative (Scheduler) will be required to follow any other instructions and to perform any other related duties as assigned by the supervisor and his/her assignees. Arrowhead Orthopaedics reserves the right to update, revise or change this job description and related duties at any time.

Requirements

  Performance Requirements:

• To perform this job successfully, an individual must be able to perform satisfactorily job duties, demonstrate excellent work habits, deliver superior service, and exhibit the highest degree of professionalism.
• Employ positive communication skills and exercise professional interpersonal abilities (tack, diplomacy, and respect) with patients and co-workers always. 
• Maintain a high degree of professionalism in the workplace, including appearance, communication, attendance, reliability, and teamwork.
• Maintain a high level of organization, including an orderly and neat work area and excellent time management skills, leading to the highest level of productivity.
• Demonstrate a desire to succeed and willingness to help others succeed. 
• Demonstrate support and comply with all Safety program elements including adherence to policies, exercise of safe work practices, participation in training, use of protective equipment, and reporting all safety concerns, hazards, and      non-compliant practices.
•  Serve as an employee for Arrowhead Orthaepedics, following the code of conduct, displaying the highest level of ethics and integrity in action, thoughts and conduct. 

Skill Requirements: 

• High school diploma or equivalent required.
• The ability to type 40 words per minute
• Previous call center, medical office, or healthcare customer service experience preferred.
• Knowledge of medical terminology
• Proficiency with computers and common software, experience with electronic medical records (EMR)
• Strong verbal and written communication skills.
• Excellent customer service and interpersonal skills.
• Ability to multitask, prioritize, and work efficiently in a fast-paced environment and must be flexible.

Typical Physical Demands:

1. Requires sitting and walking, with daily occasional stooping, reaching, and bending.
2. Occasional lifting up to thirty pounds.
3. Hearing must be in the normal range for telephone and personal communication.
4. Requires manual dexterity sufficient to operate keyboards and other office equipment.