Reports to: Contact Center Manager
Position Overview:
The Patient Services Representative (PSR), in the Contact Center is responsible for the management of incoming phone calls and inbox messages from patients. This role is often the first point of contact that patients and other personnel will have with MIT Medical. The position must demonstrate excellent customer service skills, empathy, detailed communication, ability to de-escalate and provide resolution. The PSR will process registration of new patients, ensure accurate insurance eligibility information, schedule appointments, advise of co-pays, pre-visit process, answer general inquiries, screen callers for triage, and coordinate with internal and external service areas. This position effectively communicates with patients, providers, and other service areas and troubleshoots complex patient inquiries.
Principal Duties and Responsibilities*:
- Provide exceptional phone services to patients and family members in a professional and courteous manner.
- Verifies all demographic and insurance information, making changes as necessary.
- Ensures proof of active insurance at the time of patient registration and appointment scheduling.
- Advises patient on co-payment options
- Facilitates and directs communication to Revenue Cycle Dept. when questions of payment ability arise.
- Maintains an understanding of all health insurance plans, financial services, and self-pay resources, specifically focusing on those sponsored by MIT and Medicare. Appropriately refers patients to Health Plans Member Services when questions arise regarding benefit and referral issues. Maintains basic knowledge of medical terminology and ICD10 coding
- Manages both inbound and outbound phone calls, emails, and/or other standard patient inquiries by answering, screening, and routing inquiries as dictated by service area workflows.
- Records messages in appropriate tracking log(s) and forwards said messages as per standards for triage and/or other urgent information or services.
- Respond to requests for routine information or assistance within the scope of knowledge and authority. Screens and manages more complex telephone calls, utilizing courteous customer service skills. Initiating calls for emergency services as required.
- Answers all incoming calls, takes messages, and routes appropriately.
- Notifies RNs as appropriate and in accordance with agreed protocol.
- Working directly with each patient (or their HIPAA-approved representative), schedules and records all encounter appointments, communicating patient confirmation and reminders as established by service area standards.
- Coordinates patient visits with other MIT Medical Specialties, diagnostic testing, and/or off-site practices to ensure that patients are seen in a timely manner. Communicates with the primary care provider or designee when necessary to escalate scheduling roadblocks.
- Processes all necessary referrals and follows up on all insurance questions and inquiries as needed.
- Other duties as assigned.
Minimum Required Education and Experience:
- High school diploma or GED equivalent required.
- Minimum two years of previous experience such as customer service or administrative role required. Prior experience in a health care setting is a plus.
- Ability to perform multiple tasks simultaneously.
- Effective telephone manner and ability to communicate with patients, clinicians, and other professional staff in a pleasant, calming, and diplomatic manner.
- Strong organizational and follow-through skills.
- Math skills; ability to add, subtract, multiply, and divide with accuracy.
- Ability to work independently or within a team environment.
- The ability to work with diverse internal and external constituencies.