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Patient Advocacy Specialist

2 months ago

Reno, Nevada, United States Renown Health Full time

Position Overview

This role serves as the primary point of contact for individuals seeking healthcare services, ensuring that they receive timely assistance with a focus on delivering an outstanding customer experience. The individual in this position will act as a liaison, primarily advocating for patients, between Renown Health, its clients, and community stakeholders. Responsibilities include processing inquiries, addressing complaints, providing education on utilizing available resources, and striving for 'first call resolution'. A successful Patient Advocacy Specialist is dedicated to exceeding expectations and delivering exceptional service in a professional and efficient manner. This role is fulfilling as it allows for making a meaningful impact on the lives of those served.

Key Responsibilities

This position requires working in a dynamic environment, utilizing various communication methods such as face-to-face interactions, video calls, phone conversations, chat, messaging, and email. The representative must be adept at mastering the systems and technologies relevant to the role while efficiently multitasking.

Strong interpersonal skills are essential for understanding customer inquiries or concerns and navigating potentially challenging conversations. Representatives must maintain high service levels while managing complex situations and significant volumes of interactions. They will advocate for customers, ensuring they receive top-tier service by proactively identifying and escalating priority issues, de-escalating when necessary, and going the extra mile to fulfill customer needs. Quick learning is vital to acquire the necessary service and product knowledge to accurately respond to customer questions. Documentation must be precise and accurate, utilizing correct grammar and complete sentences.

The Engagement Center operates on a set schedule, and representatives are expected to be present for their entire shift in a quiet, private environment that complies with privacy standards. Flexibility in working hours is required to meet customer needs, which may include evenings, nights, weekends, and holidays.

Responsibilities include, but are not limited to:


• Delivering exceptional service by utilizing foundational knowledge of all services offered by Renown Health.


• Adhering to established policies and procedures to fulfill tasks, meet customer needs, and achieve first call resolution.


• Managing a high volume of inbound and outbound communications across multiple channels and software systems, effectively resolving inquiries.


• Coordinating healthcare services, including scheduling appointments, updating patient records, obtaining authorizations, liaising with care teams, arranging transportation, escalating patient concerns, and addressing general complaints.


• Providing accurate information regarding plan benefits, including eligibility, benefit details, provider networks, referral processes, claims payments, and organizational policies.


• Collaborating effectively with healthcare professionals, including providers, social workers, case managers, nurses, and insurance representatives.


• Addressing inquiries related to compliance and regulatory matters.

Additional duties may be assigned as necessary, with an emphasis on meeting and exceeding performance goals to achieve departmental and organizational objectives.

Disclaimer

This description is not intended to be an exhaustive list of all responsibilities, skills, and efforts associated with the position. It aims to accurately reflect the general nature and level of the role.

Minimum Qualifications

Education: Proficiency in the English language, including reading, writing, and speaking, is required. A college degree or equivalent experience is preferred but not mandatory.

Experience: Strong customer service skills are essential, with a preference for 1-2 years of experience in customer service, healthcare, or health insurance. Bilingual abilities, particularly in Spanish, are advantageous.

Licenses/Certifications: None required.

Computer Skills: Proficiency in Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word, is necessary. Ability to type at least 40 WPM and experience with electronic medical record systems is a plus.