Remote Claims Trainee Jobs in Boca Raton, FL (NOW HIRING)

Bilingual Spanish Speaking Preferred

Schedule: 

Tuesday-Saturday: 12:30 pm-6:00 pm MT

PRIMARY FUNCTION

Answer incoming calls from our patients to provide outstanding customer service in support of our mission, goals, and values.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This list may not include all the duties that may be assigned.

1) Answer incoming calls by welcoming patients with a professional, upbeat, friendly attitude.

2) Follow prepared scripts based on call type.

3) Register new patients by gathering pertinent information and entering XPM system.

4) Verify insurance coverage and information.

5) Set patient appointments upon request and identify future visits.

6) Document accurately and efficiently within all systems (XPM, CRM, EHR).

7) Document all questions and messages for Clinicians and label them properly using our telephone communication access protocol.

8) Data entry and maintenance of customer databases.

9) Properly obtain and confirm patients/caller information abiding by HIPPA law.

10) Collect all necessary and pertinent information over the phone to facilitate timely and accurate physician follow-up.

11) Complete any necessary referrals requested by telephone contact for provider approval.

12) Provide customers with product and service information.

13) Respond to patient inquiries.

14) Research required information using available resources.

15) Communicate with offices when necessary.

16) Handle customer complaints and other customer support related issues and provide customers with proper solutions.

17) Meet established standards within all performance criteria.

18) Attend any necessary training/meetings to be up to date on protocol changes and available training.

19) Other duties may include, but are not limited to, outbound calls, copying, faxing, etc.

Below are additional functions of the job for Patient Contact Center Representatives that will perform as clinical agents: (This list may not include all the duties that may be assigned.)

20) Provide medical guidance via telephone using our telephone communication access protocol, clinical triage algorithms, and clinical judgment.

21) Document all medical advice given over the phone.

22) Schedule appointments using clinical prioritizing protocols and our scheduling policies.

23) LPNs and Registered Nurses answer calls and questions from Patient Contact Center Representatives and can triage high acuity patients.

QUALIFICATIONS

EDUCATION:

· High School diploma or equivalent.

EXPERIENCE:

· Prefer minimum of one year experience in a call center environment.

· Knowledge of XPM and CRM system desired.

· Familiar with automated call distribution, IVR, and skill-based routing systems.

· Previous customer service experience required.

LICENSURE / CERTIFICATION

· Representatives that are performing as Clinical Agents require at least one of the following licensures or certificates.

· MA diploma or certificate (1), LPN (2) or Registered Nurse (3).

KNOWLEDGE, SKILLS, AND ABILITIES

· Knowledge of XPM/EHR and Contact Recorder desired.

· Familiar with automated call distribution, IVR, and skill-based routing systems.

· Must have strong verbal, written, and interpersonal communication skills.

· Experience with coaching and mentoring employees.

· Demonstrates ability to work well in a team environment.

· Strong multi-tasking skills.

· Attention to detail, accuracy and timeliness are critical.

· General PC knowledge including Microsoft Office, Internet, and Email.

· Needs to be proficient in Power Point.

TYPICAL WORKING CONDITIONS

· Patient-facing

· May be either full time remote/telework or rotate working in the office and remote/telework.

· This job must be U.S. based.

· Working in a professional office environment.

· The position involves high & frequent call volumes.

· Environment requires ability to multi-task, communicate clearly & concise, data entry for extended period of times.

· Will require sitting for long periods of time.

OTHER PHYSICAL REQUIREMENTS

· Vision

· Sense of sound

· Sense of touch

PERFORMANCE REQUIREMENTS

Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI (Protected Health Information) in accordance with organizational policy, Federal, State, and local regulations.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to be an accurate reflection of the general nature of level of the job.

I have read the above job description and my supervisor has discussed it with me and I understand the responsibilities of the job for which I have been hired. I acknowledge that I have assumed responsibility for carrying out these tasks to the best of my ability and in accordance with company policies.