Job Summary:
The Customer Service Representative is the first point of contact for patients and the community. This position is responsible for general receptionist duties, completing financial assessments, and preparation of patient charts.
Supervisory Responsibilities:
None.
Duties/Responsibilities:
Customer Service Representative I
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Performs general receptionist duties including greeting patients, answering the telephone and channeling calls, taking messages, scheduling appointments, contacting patients, and filing.
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Assesses patient fees, receives payments, issues receipts, maintains cash balance, and assists with maintenance of patient files.
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Prepares and/or develops patient charts and assigns patients to a nurse/physician. Updates, completes and/or verifies patient demographic and financial information and ensures that it is accurately scanned and entered into the patient chart.
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Identifies and verifies patient’s insurance coverage or other sources for payment of services and ensures that the information is accurately entered into patient chart.
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Utilizes and maintains an organized office operation that includes a comprehensive filing system of correspondence, patient records, and inventory.
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Translates or assigns staff to translate for clinical staff when needed in both verbal and written materials.
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Ensures appropriate referrals to CSR 3 staff when patients identify additional financial and/or resource assistance is needed.
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Performs other duties as assigned.
Duties 1-7 are designated as ADA Essential Functions and must be performed in this job. All other job duties are secondary functions.
Customer Service Representative II
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Can perform all Customer Service Representative I duties listed above.
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Responsible for opening and closing duties, such as issuing drawer keys and verifying daily deposits.
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Responsible for understanding and determining eligibility for, and applying sliding fee schedules accurately.
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Sets initial slides and conducts reminder phone calls to patients who need to provide financial documentation.
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Responsible for following up with patients who have pending sliding fee applications.
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Enrolls patients into patient portal.
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Performs other duties as assigned
Duties 1-6 are designated as ADA Essential Functions and must be performed in this job. All other job duties are secondary functions.
Customer Service Lead
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Can perform all Customer Service I and II duties listed above.
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Trains and orients new Customer Service Representatives under the Customer Service Manager’s supervision; completes competencies as requested.
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Serves as liaison between the Customer Service Manager and Customer Service Representatives to address day-to-day questions and issues.
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Completes the bi-weekly staffing schedule and works as a team to ensure coverage which may require working at any of MHC’s locations.
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Establishes an organized office operation.
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Responsible for maintaining the petty cash drawer and auditing monthly.
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Completes a monthly audit of cash drawers.
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Processes and posts incoming payments not taken in at reception.
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Works with the Customer Service Manager to audit Budget Plan enrollments and payments.
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Performs other duties as assigned.
Duties 1-9 are designated as ADA Essential Functions and must be performed in this job. All other job duties are secondary functions.
Customer Service Representative III
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Can perform all Customer Service Representative I & II duties listed above.
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Assists in the development of and ensures the distribution of outreach materials to targeted community members.
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Recruits targeted individuals for program participation through workshops, community meetings, surveys, broadcast and print media, and other activities.
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Regularly contacts local service organizations to ensure appropriate referrals are made to Midtown Health Center.
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Keeps abreast of issues facing targeted populations.
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Work to continually build new relationships and maintain existing ones with current and future community entities that are providing services to consumers to promote health insurance coverage through the Federal Marketplace, Medicaid and or CHIP along with agencies providing Social Service assistance.
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Responds to requests for assistance by assessing service needs and providing direct intervention, information and referral services as appropriate.
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Follows-up on referrals in order to asses outcomes and provide additional services as needed.
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Provides new patient orientation sessions, performs initial screening to include suitability and eligibility.
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Maintain knowledge and expertise in eligibility, enrollment and program specifications of the Federal Marketplace and other health coverage programs such as Medicaid and CHIP.
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Assists patients and non-patients in securing access to available health, social service and other assistance programs. Programs include but are not limited to Medicaid, SNAP, Economic Assistance (TANF), Every Woman Matters, Health Insurance Marketplace and CHIP.
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Provides enrollment assistance to patients and non-patients to Qualified Health Plans in the Marketplace.
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Administers the Madison County General Assistance program on behalf of Madison County to help patients and non-patients with costs within the program guidelines.
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Completes patient records to include eligibility documents, assessment forms, information and referral logs and other records as assigned.
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Maintains files and records of individuals served, services provided, outreach activities conducted, surveys completed and any other general reporting requirements.
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Coordinates and educates Midtown Health Center staff on opportunities for patients.
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Conduct public education activities to raise awareness about the Health Insurance Marketplace.
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Participate in regularly scheduled conference calls, meetings and trainings to provide accurate, quality services. This includes participation in the Centers for Medicare and Medicaid Services trainings and other required training to maintain CAC and/or Navigator certification and to enhance outreach and enrollment expertise.
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Provide data and other information necessary for CMS and other reporting requirements.
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Performs other duties as assigned.
Duties 1-19 are designated as ADA Essential Functions and must be performed in this job. All other job duties are secondary functions.
Knowledge, Skills, and Abilities:
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Ability to efficiently carry out Midtown Health’s Center mission statement and comply with its policies and procedures.
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Ability to establish and maintain effective working relationships with patients, co-workers, and the public and to be able to demonstrate cultural awareness and sensitivity.
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Must be able to maintain strict confidentiality of sensitive information in accordance to HIPAA regulations.
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Ability to comply with all occupational safety and health standards and all rules, regulations, and orders issued under the Occupational Safety and Health Act (OSHA).
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Ability to utilize critical thinking and problem solving skills to address clinic’s needs.
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Ability to interpret oral and written instructions and do appropriate follow-up.
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Ability to work independently and as a team member.
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Must have exceptional time management and organizational skills.
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Ability to constructively participate in quality improvement efforts.
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Ability to actively participate in marketing and outreach activities when requested and emergency response events when required.
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Bilingual (English/Spanish) verbal and written skills highly desired.
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Proficient in Microsoft Office applications and data base application.
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Ability to operate standard office equipment including, but not limited to computers, printers, copiers, scanner, calculators, facsimile machines, and telephone systems.
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Ability to run a multi-line telephone system.
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Must have a general knowledge of medical terms.
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Ability to learn electronic health record system.
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Must understand the differences between and among self-pay patients, insurance patients, Medicare patients, workers’ compensation patients, and occupational medicine patients.
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Must have excellent customer service skills, including de-escalation.
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Must have strong oral and written communication skills.
Education and Experience, Licensure and Certification:
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High school diploma/GED preferred.
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Experience in a medical office setting preferred.
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Must have a valid driver’s license and the ability to utilize own transportation for work purposes.
Physical Requirements:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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Maintain physical condition appropriate to the performance of assigned duties and responsibilities which may include sitting or standing for extended periods of time.
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Must have the ability to exert up to 20 pounds of force occasionally and/or a negligible amount of force constantly to move objects.
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Requires frequent bending, stooping, or stretching.
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Ability to reach by extending hand(s) and arm(s) in any direction.
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Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard.
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Vision and hearing within normal parameters to perform job requirements.
Working Conditions/Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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Ability to work varied and extended hour scheduling as requested including early mornings, evenings, and occasional weekends.
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Ability to work in a smoke-free and drug-free work environment.
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Position may be located in a busy, open office area and may be faced with interruptions.
Other Duties:
This job description is not designed to cover or contain a comprehensive listing of duties or responsibilities that are required of the employee for this job. Duties and responsibilities may change at any time with or without notice.
EEO Statement:
Midtown Health Center is an equal opportunity employee and will consider all qualified candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or because he or she is a protected veteran.
