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Client Support Specialist

2 months ago

Appleton, Wisconsin, United States Catalpa Health Full time
About the Role

Catalpa Health is seeking a highly skilled and dedicated Client Support Specialist to join our team. As a Client Support Specialist, you will play a critical role in providing exceptional customer service to our clients, ensuring a positive experience from the moment they interact with our organization.

Key Responsibilities
  • Welcome clients and their family members with a warm greeting, using their name and making eye contact.
  • Use professional and courteous language, maintaining a positive tone in every interaction.
  • Actively listen to clients to best meet their needs, showing empathy and understanding.
  • Keep clients informed of any delays in the process, taking responsibility for client satisfaction.
  • Properly address client concerns and requests, referring them to appropriate staff when necessary.
  • Complete consult referrals, prior authorizations, and inform clients of those appointments.
  • Understand and follow proper steps to search for client records and set up new accounts, validating, verifying, or adding insurance, including third-party insurance.
  • Adhere to departmental expectations, including attending required meetings, participating in quality and process improvement projects, and service recovery.
  • Identify provider schedule capacity and analyze availability for client demand to maximize provider efficiency and schedule utilization.
  • Create and manipulate schedules for individual clinicians and physicians.
  • Compile office charts for appointments one day in advance.
  • Maintain knowledge or experience in billing and insurance principles and practices.
  • Keep current with all process changes.
  • Maintain confidentiality of client information.
Registration/Scheduling Responsibilities
  • Strive to understand and meet the needs of clients, which may involve multitasking and switching gears quickly while completing various tasks, including checking in, collecting payments, scheduling, rescheduling, coordinating multiple appointments, and canceling appointments.
  • Verify client information, including insurance and demographics, prior to or upon check-in.
  • Stay current on registration workload.
  • Ensure that necessary questionnaires are completed for client visits.
  • Follow appropriate guidelines and update the clinical team for situations when a client cannot be seen, such as late clients, terminated clients, insurance coverage not accepted, or red flag issues.
  • Perform cashiering functions, including collecting co-payments and self-pay balance payments, voiding payments as needed, and researching issues prior to closing.
  • Maintain a neat, clean, and professional work area, keeping client waiting areas clean, organized, and with current resource materials.
Call Center Responsibilities
  • Answer all incoming calls, identify the need of the caller, and document messages as required.
  • Triage calls for clients and professionals to ensure excellent customer service.
  • Route emergency calls to the nursing and/or case management team in accordance with the emergency procedure.
  • Enter complete and accurate phone messages in the computer and send to the appropriate clinical staff.
  • Provide counseling to clients or their guardians regarding pre-service requirements and instructions.
Prior Authorization Responsibilities
  • Check all MA authorizations from clinicians to ensure correct sessions, etc., are authorized before transmittal.
  • Keep clinicians and billing representatives informed of any changes in the authorization process.
  • Educate clients and team members regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance-related changes or trends.
  • Understand all authorization procedures, including but not limited to, UBH, MA, and assist clinicians in this process to maximize reimbursement for the organization.
  • Assist clinicians in distributing treatment plans to insurance companies within the guidelines of the authorization process.
  • Notify clients and providers of any services requested and/or referred that are not authorized by insurance.
Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Education/Experience:
    • High school diploma required
    • 1+ years of experience working in a clinical setting is preferred. Customer service and working in an office setting is preferred.
  • Certifications & Licenses:
    • Name
    • Required/Preferred
    • N/A
    • N/A
  • Skills and Abilities:
    • Proficient and accurate typing skills required.
    • Knowledge of medical terminology is preferred.
    • Deductive reasoning.
    • Ability to work under pressure with accuracy.
    • Excellent attendance in previous work environment.
    • Demonstrates intermediate computer skills and knowledge of computer software programs.
    • Effective verbal, written, and interpersonal communication skills.
Working Conditions and Environment

Work is performed at the corporate location, with an office setting, indoor, and climate-controlled. Catalpa Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.