Patient Services Rep

Overview

CHI Saint Joseph Medical Group now part of CommonSpirit Health formed between Catholic Health Initiatives (CHI) and Dignity Health includes 275 providers delivering quality care to patients across 88 locations in central and eastern Kentucky. Our full service network delivers a variety of Primary Care Services including Family Internal Geriatric and Pediatric Medicine in addition to several specialties to deliver custom care based on the unique needs of our patients.

Responsibilities

Job Summary / Purpose

CHI starts out with one goal at our core - Excellent care, delivered with compassion, for all in need. Working with Dignity Health provides employees with the opportunity to positively affect the health and well-being of entire communities.

By uniting 'Healing and Humankindness' we work together with our physicians and health care experts to provide the best care experience to our patients and the communities we serve. As part of the CHI Team, you'll work in a culturally diverse environment that supports your success and career development. The Patient Service Medical Assistant Representative position is the first point of phone customer service contact for our patients, physicians, other clinic staff, internal and external laboratory and imaging staff, hospital staff, patient family members, and vendors.

As a Patient Service Medical Assistant Representative, your role is to provide prompt, accurate, and courteous interactions including communicate lab and test results to patient per CHI Saint Joseph Health Medical Group. This position will interact with all callers through a variety of communication channels including voice, chat, email and text.

A Patient Service Medical Assistant Representative may also perform a variety of other duties including but not limited to collecting and updating demographics and insurance information, verification of health plan eligibility, taking complete and accurate messages, and scheduling mutually acceptable appointment times utilizing an electronic appointment management system, electronic health record, and contact center system. In addition, may assist with referrals and authorizations. As the first point of patient contact your role is to provide effective patient experiences with an emphasis on first contact resolution in a culture of 'yes'. Patient Service Medical Assistant Representatives may assist with patient calls from multiple locations and specialties, and hours may vary as needed.

Essential Key Job Responsibilities

• Patient Service

1.1 Schedule and register patient appointments and/or provide information for other requests (e.g., addresses/directions, phone numbers, hours of operations, other departments, such as billing, etc.). Process all phone, fax, email, and other communication channel requests with an emphasis on efficiency and accuracy.

1.2 As appropriate, train and handle onboarding of new members to departmental standard operating processes, explanation of available services, tools, resources, and availability of providers.

1.3 Update patients of the status of their referral or authorizations.

1.4 Answers, screens, and processes a high volume of incoming calls in a professional manner. Directs patient access to the practice by scheduling and canceling patient appointments for multiple providers.

1.5 Utilizes and adheres to a phone script, clinical decision trees and scheduling criteria following department guidelines. Uses independent knowledge within scope of knowledge and training to determine the type of appointment needed and urgency to schedule the patient to the appropriate provider or route the call to the appropriate resource.

1.6 Communicates, to patients and internal and external ordering physicians' offices, complex exam preparations instructions including, but not limited to, appointment arrival expectations, necessary documents requirements, outstanding balances, estimated co-pays, and other necessary preparations instructions in a courteous manner.

1.7 Documents clinically relevant findings in the patient's record following DHMF approved protocols.

1.8 Reports significant observed or reported alterations in the patient's condition to the RN, physician, supervisor or nurse manager following DHMF approved protocols.

1.9 Proposes approved orders based on clinical findings to the assigned provider and notifies appropriate parties within expected timeframe.

1.10 Sends out accurate and complete communication to physicians or other healthcare providers.

Responsibilities

• First Contact Resolution

2.1 Determine the reason for the call and assist the caller with their questions, concerns or problems with the focus on first call resolution. Facilitate patient issue-resolution by referring the matter to the RN, physician, supervisor or issue/content expert.

2.2 Support other team members with escalation concerns guiding them in the correct process.

2.3 Escalate the matter to a supervisor, request the appropriate information or take appropriate action so that the issue expert is able to effectively resolve the matter.

3 Contact Handling

3.1 Ability to comprehend and communicate clearly and effectively (both verbally and in writing in all communication platforms) with medical center staff, patients, families, and other internal and external customers.

3.2 Train and provide on-going support for other team members in effectively utilizing communication tools and documenting interactions in applicable systems.

• Flexibility

4.1 Ability to perform essential job functions with a high degree of independence, flexibility and creative problem solving.

4.2 Capable of supporting various responsibilities and providing back up support to other areas that may change day to day to ensure the department is running effectively and efficiently, meeting productivity measures.

5 Contact Control

5.1 Ability to maintain control of the call by de-escalating issues and instilling confidence that the resolution has or can be found. Ability to clearly articulate a response to the patient using appropriate voice modulation.

5.2 Train team members in proper contact control and supporting them in de-escalating issues.

6 Problem Solving

6.1 Exceptional patient/customer service skills including effective and efficient problem solving and analytical skills.

6.2 Participate in investigations of reported issues and provide root cause analysis feedback to appropriate leadership.

6.3 Identify continuous improvement opportunities and collaborate with leadership to support implementing identified solutions and process changes including updating documents and supporting training of team members.

7 Contact Quality

7.1 Meet quality assurance requirements and other key performance metrics.

8 Professionalism

8.1 Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

9 Proactively contributes to Organizational Excellence

9.1 Focus at all times on improving the patient's experience by delivering on a culture of yes.

9.2 Problem solves to maximize opportunities and minimize unnecessary steps.

9.3 Keeps work spaces and all community areas clean and clutter free.

9.4 Maintains professional appearance and follows all dress code guidelines.

9.5 Flexible to change work hours/days, and floats to support others.

9.6 Initiates ways to improve team productivity.

10 Demonstrates effective stewardship

10.1 Utilizes and maintains equipment properly to minimize repair and service calls, maximize equipment longevity and increase cost effectiveness.

10.2 Requests only necessary items, effectively utilizes supplies minimizing waste, and shares supplies to eliminate unnecessary spending.

10.3 Utilizes work time efficiently through proper time management.

10.4 Adheres to time and attendance policies and procedures.

10.5 Promptly refers patients to the billing office for extensive billing questions.

10.6 Documents insurance card, referral, authorizations and other eligibility and billing data.

11 Continuously challenges status quo

11.1 Encourages feedback from patients and co-workers.

11.2 Seeks alternative ways of doing things quicker with less resources.

11.3 Ask questions.

11.4 Reports items that require attention and participates in the root cause analysis and implementation of the solution.

11.5 Shares ideas and gives feedback.

11.6 Supports updating of tools and resources.

12 Safety, Confidentiality and Training

12.1 Can verbalize fire and disaster plans.

12.2 Meets all OSHA standards applicable to the department.

12.3 Participates and completes all required training, both in-person and on-line, timely.

12.4 Knows how to utilize the incident reporting system and compliance hotline.

12.5 Adheres to all patient confidentiality requirements.

The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.

Qualifications

Required Education

High School Diploma or equivalent.

Experience

Minimum of two (2) years experience in a patient-focused healthcare environment OR high volume multichannel contact center. Experience with computer systems required, including office windows based programs and web based applications.

Education

Required Licensure and Certifications

Current Certified Medical Assistant Certification

Required Minimum Knowledge, Skills, Abilities and Training

Must pass the contact center assessment and pass a typing proficiency assessment.

Must pass Medical Assistant assessment.

Must pass contact center final exam after completing the contact center training course.