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Customer Service Specialist I

4 months ago

Costa Mesa, United States Hoag Memorial Hospital Presbyterian Full time

**Salary Range**: $19.8400 - $30.5000 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education.

This individual projects an image of professionalism in communication and conduct at all times to ensure a positive experience for the patient, physician, visitor, colleague or partnering departments. The Patient Scheduling Specialist mission is to maintain a patient centric philosophy throughout all processes and procedures. They are the initial contact representative for a patient or physician calling Hoag Hospital in which to establish appointments, inquire about financial questions, Hoag Portal, pre registration, exam preparation and coordination of services. They function as a liaison for those we serve and possess an extensive knowledge of the actual procedures, precertification, and financial requirements unique within each contract, department or facility under the Hoag brand.

**Level 1**:
This position requires the ability to perform all functions within the SERVE (Schedule, Educate, Register, Verify and Estimate essential job functions. Estimation requires scheduler to submit to eligibility vendor and eligibility team for patient follow-up for a patient. Effectively handles 30+ transactions per day for several different departments and services with mínimal or no error. This level can take calls from main department line. This level can include staff that pre register and schedule for one or two departments in addition to other departments of radiology or new departments for CPS. This level meets all requirements for excellent customer service by maintaining excellent patient and physician satisfaction rating. Schedulers in this level are reviewed after 6 months of scheduling in multiple departments to determine expertise to Level II scheduling.

**Essential Functions**
- Extensive knowledge of scheduling and preparation of procedures and visits for all departments within Hoag Enterprise using the Unibased System and interfacing clinical systems and ADT system. Escalates issues or concerns to ensure the optimizing of services delivered with mínimal impact.
- Overall knowledge of the revenue cycle process, registration, insurance verification, precertification, billing compliance, payer contracts, patient estimation, financial assistance, ICD9, CPT, CMS regulations, DNFB and claim processing. The SERVE TEAM, schedules, educates registers, verifies and estimates services for the patient with a “one call does it all” initiative.
- Responsible for accurately scheduling appointments within a centralized department, which provides education to the patient and offices, full patient registration, verification of insurance, precertification requirements for services, patient estimation of services, collection of co-pay, deductibles and coinsurance as required. Providing the patient with comprehensive service thereby reducing call transfers, redundancy of questions, and unnecessary call back to the patient
- Participates as a key member of the SERVE Team, maintaining hospital initiatives, mission and vision to ensure a high quality patient experience. Partners with clinical departments on policy and scheduling implementation and changes. Provides service to those departments maintaining quality SERVE responsibilities.
- Serves as a resource for problem solving and communications. Analyzes the patient feedback for process/system resolution when appropriate. Knowledgeable of resolution process and outcomes of ongoing patient complaints and concerns.
- Utilizes protocol for patient look up to ensure accurate identification of patient to ensure data integrity and patient safety
- Accommodates requests from patient and physician offices for STAT same day procedures. Effectively prioritize calls using courteous professional demeanor to ensure high patient satisfaction.
- Ensures prescription orders from physician’s meets hospital compliance for signatures, diagnosis, and services to ensure hospital coding for submission of clean claim.
- Obtains and evaluates all relevant data to handle complaints and inquiries. Resolves customer support related issues and provides customer with proper solution, via troubleshooting techniques. Performs duties independently and uses judgment in handling a variety of patient experience issues.
- Maintain required productivity volumes based on expected skills and specifications for current level. Performs customer verifications, processing orders and requests. Completes call reports, logs, work-lists and respond to billing issues.
- Effectively uses multiple software systems to complete schedule/registration process.
- Effectively screens and edits confidential correspondence and documents related to patient care and sensitive administrative issues in accordance with established policies and procedures. Coordinates changes, postponements, cancellations and preferred order of cases with physicians, patients and department staf