Customer Care Specialist

2 weeks ago

Ann Arbor, Michigan, United States IHA Full time

POSITION SUMMARY:


Responds to incoming inquiries, evaluates the urgency of each call, and effectively triages and directs critical calls in accordance with established protocols to guarantee the highest quality of patient care.

Arranges patient appointments and collaborates with clinical staff to enhance patient care and operational efficiency.

Handles patient referrals and prior authorizations by processing requests from both internal and external stakeholders, ensuring timely and accurate completion of all requests.

Delivers exceptional customer service to all clients and partners.

KEY RESPONSIBILITIES:


Responds to incoming calls, assesses urgency, and appropriately triages and directs urgent inquiries to ensure optimal patient care.

May schedule appointments for urgent issues; collaborates with clinical staff to streamline patient care and operational efficiency.
Accurately and efficiently pages on-call providers as needed.
Schedules patient appointments; gathers necessary information and inputs preliminary account data into the system.

Records messages for physicians and staff with complete and accurate information, ensuring proper tasking through the electronic medical record system.

Assists patients with inquiries related to the patient portal. Stays updated on portal changes, updates, and frequently asked questions.
Completes call center documentation accurately. Utilizes the call log and on-call provider calendar effectively.

Monitors and follows up on all referral requests and authorizations for outpatient services and/or surgeries, which may involve contacting specialists, insurance companies, practices, and patients.

Secures out-of-network authorizations when feasible to assist patients in complying with Primary Care Provider requests.

Documents notes in the electronic systems regarding the status of referrals, authorizations, or other patient-related information; addresses inquiries from patients, insurance companies, and office calls regarding referrals and prior authorizations.

Maintains familiarity with office services and operational hours to respond to customer inquiries accurately and promptly.

Ensures that any outstanding items from previous shifts are resolved appropriately.
Performs additional duties as assigned.

ORGANIZATIONAL STANDARDS:


Fosters a positive, professional, service-oriented work environment for staff, patients, and family members by supporting the mission and values of IHA.

Must work effectively as part of the Call Center team.

Successfully completes IHA's customer service training and adheres to IHA's standards of providing high-quality service and respect to all customers.

Maintains knowledge of and complies with IHA standards, policies, and procedures.
Maintains comprehensive knowledge of office services and proficiency in all relevant office equipment and systems.
Ensures strict confidentiality of patient and employee information in accordance with IHA and HIPAA regulations.
Serves as a role model by demonstrating exceptional capability and willingness to take on new responsibilities. Embraces innovative ideas and respects cultural diversity.
Utilizes resources efficiently.

If applicable, responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials, and participates in available training opportunities.


PERFORMANCE MEASURES:
Performance that meets or exceeds IHA CARES Values expectations as outlined in the IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS:

EDUCATION:
High school diploma or equivalent
CREDENTIALS:

LICENSURE:
None

MINIMUM EXPERIENCE:

Up to 3 years of prior experience in patient services, medical reception, call/customer service center (medical environment), or other relevant business environments.


POSITION REQUIREMENTS (ABILITIES & SKILLS):
Knowledge of call center protocols, processes, and procedures related to job responsibilities.
Basic mathematical skills.

Proficient in using standard desktop and Windows-based computer systems, including but not limited to, electronic medical records, telephony systems, Microsoft Word, and Excel.

Ability to utilize other software as required while performing essential job functions.
Excellent communication skills in both written and verbal forms, including proper phone etiquette.
Ability to work collaboratively in a team-oriented environment; courteous and friendly demeanor.

Ability to interact effectively with various levels of organizational members and diverse populations including staff, providers, patients, family members, insurance carriers, and vendors.

Ability to cross-train in other areas of the department to ensure smooth operations.
Ability to work a flexible schedule during assigned shifts and cover absences in other shifts as needed.
Strong organizational and time management skills to effectively manage multiple priorities and deadlines.

Ability to exercise sound judgment and problem-solving skills, particularly in resolving or escalating complex issues as necessary.

Ability to handle sensitive patient and organizational information confidentially.
Successful completion of IHA competency-based training during the introductory and training period.
Basic knowledge of medical terminology, billing, insurance, referrals, and authorizations to fulfill job responsibilities.

MINIMUM PHYSICAL EXPECTATIONS:
Physical activity that often requires keyboarding, filing, and phone work.
Physical activity that often requires extensive time working on a computer.
Physical activity that sometimes requires walking, standing, bending, stooping, reaching, and/or twisting.
Physical activity that sometimes requires lifting, pushing, and/or pulling under 30 lbs.
Specific vision abilities required include close vision, depth perception, peripheral vision, and the ability to adjust and focus.
Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment.

Must hear and speak well enough to conduct business over the telephone or face-to-face for extended periods.


MINIMUM ENVIRONMENTAL EXPECTATIONS:


This position operates in a typical office environment, which involves frequent interruptions and significant interaction with people, which can be stressful at times.

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