Contact Center Specialist
Lancaster General Hospital
2022 Sched/Insurance Validation
PFS Contact Center-Centralized Scheduling
POSITION SUMMARY: The Contact Center Specialist provides complete and accurate patient scheduling, registration, insurance verification, ordering of tests and coordination of applicable screening, diagnostic, physician office and outpatient hospital services. This position assists customers with their stated and unstated needs by offering guidance and support, while making personal connections with each customer.
ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:
- Provides customer service by identifying and addressing customer needs and builds positive interpersonal relationships with customers and team members. Uses sound judgment in handling calls, especially with difficult interactions. Engages personally with the patient and demonstrates strong interpersonal skills via empathy, compassion, and celebration when appropriate.
- Demonstrates ability to successfully adapt and perform during times of high contact volumes, excessive wait times, and patient acuity, as well as adapt to frequent changes to procedures and workflows. Demonstrates skills to serve both outpatient and physician office customers, as needed.
- Interviews customer to collect and document accurate and comprehensive registration information including first level financial clearance. Performs required referral/authorization processes and enters orders for applicable tests.
- Demonstrates knowledge of insurance company coverage and referral/authorization requirements of payors. Performs electronic and manual verification of insurance coverage and understands how to read and accurately apply electronic insurance responses.
- Schedules appointments that meet the customer’s needs while following all departmental and organizational guidelines; disseminates or discusses information with the patients regarding co-pays, out of pocket expenses, pre-appointment preparation, arrival times, appropriate attire to wear, directions to sites, and any other instructions.
- Actively monitors and completes workqueues including but not limited to patient, outreach, and referral workqueues.
- Exhibits commitment to using all available training and reference materials, as well as, effective problem solving techniques when issues arise. Takes initiative to seek out any missed training or educational updates that may have occurred during absence.
- Remains up-to-date with scheduling and department protocols, including but not limited to escalation protocols, insurance/authorization rules, and practice-specific guidance for scheduling. Demonstrates ability to retain and apply these protocols before seeking out assistance.
- Documents in patients’ charts clearly and concisely, using all available tools, including non-clinical chart review, to provide appropriate and accurate information to customers.
- Notifies appropriate leadership channels, when necessary, of any escalated scheduling needs or issues and keeps them informed of all extenuating circumstances.
- Meets the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, and adherence to schedule. Contributes ideas for departmental and process improvement. Celebrates the successes of coworkers by recognizing their contributions.
SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:
- Other duties and special projects that are assigned by management.
MINIMUM REQUIRED QUALIFICATIONS:
- High school diploma or equivalent required.
- One (1) year of clerical, customer service, or administrative support experience in a highly customer-oriented organization.
- One (1) year experience with keyboarding, personal computer use, and other office setting equipment.
- Three (3) years of clerical, customer service, or administrative support experience in a highly customer-oriented organization.
- One (1) year of registration experience, point of service collection, insurance validation, understanding of compliance /regulatory guidelines and order release process(es).
- One (1) year of Epic (or equivalent Electronic Medical Record) experience preferred.
- One (1) year prior experience of Revenue Cycle in a Hospital/Medical Office Setting preferred.
- The position requires the ability to attend to more than one aspect of a situation simultaneously. It is highly likely that multiple task demands are going to be required of the individual at the same time.
New Learning and Memory:
- The position requires that an individual be able to learn new tasks quickly and effectively. Job requirements change frequently. The ability to understand and carry out detailed, involved instructions is mandatory.
Problem Solving, Reasoning and Creative Thinking:
- The position deals with issues or problems that often require thoughtful reasoning before arriving at approaches or solutions. Some independent thought, planning or origination of options and solutions is necessary. The individual must have the ability to apply principles of reasoning and problem solving to resolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Creativity, feelings or ideas: Ability to adapt to situations involving the interpretation of feelings, ideas, or facts in terms of personal viewpoint; to use creativity, self-expression, or imagination.
Influencing others: Ability to influence people in their opinions, attitudes or judgments about ideas or things; to motivate, convince or negotiate.
Repetitive work: Ability to continuously perform the same type of work for extended periods of time, according to set procedures, sequence or pace.
Performing under stressful conditions: Ability to perform under stress when confronted with emergency, critical, unusual, or dangerous situations, or in situations in which working speed and sustained attention are critical aspects of the job. Is subject to danger or risk, or to tension as a regular, consistent part of the job.
Variety and change: Ability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure involving significant differences in technologies, techniques, procedures, environmental factors, physical demands, or work situations.
Communication: Ability to exchange information with others clearly and concisely; to present ideas, facts and technical information.
Planning and control: Ability to identify task requirements and monitor progress toward accomplishment.
Interpersonal relations: Ability to maintain relationships that facilitate task accomplishment; to cooperate and resolve conflicts; to recognize needs and be sensitive of others.
EQUIPMENT USAGE REQUIREMENTS
Equipment/Tools: Computer, phone, printer, oxygen machine, wheelchair, litterl, digital thermometer, restraints and other dept specific hardware, Office supplies
Software: Microsoft Office products, Hospital Information System and other dept specific software
Rarely 0-10%; Occasionally 11-35%; Frequently 36-70%; Continuously 71-100%
- Sit: Occasionally
- Stand: Occasionally
- Walk: Occasionally
- Bend: Rarely
- Push: Occasionally
- Pull: Occasionally
- Kneel/Squat: Rarely
- Reach: Occasionally
- Twist: Rarely
- Balance: Rarely
- Climb: Rarely
Lifting: Degree of physical exertion is:
Moderate, exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.
Sensory Abilities specifically required:
WORKING CONDITIONS: Exposure to hazardous conditions/ materials is negligible.
Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards. The percentages of time spent performing job duties are estimates, and should not be considered absolute. The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole. Incumbent must be able to perform all job functions safely.
Posted on 03/12/2020