Job Location : Ventura,CA, USA
Job Summary:
This position provides high level member assistance by scheduling various appointments requested, transferring calls appropriately, composing messages, and providing general information.
Essential Responsibilities:
* Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.
* Operates in a high volume, highly structured call center environment by responding to incoming calls.
* Determines the type of appointment requested or needed, reviews scheduling mix of various physicians/providers, and them makes appointment utilizing appropriate guidelines.
* Prioritizes member needs and offers alternatives to members when appropriate.
* Utilizes superior customer service skills to provide service to members when diffusing difficult member encounters.
* Uses tact and diplomacy in handling difficult interactions with members.
* Determine if calls are urgent or emergent by listening to the member, following established guidelines, and then transferring the call to a Registered Nurse when appropriate.
* Composes messages for physician/providers, Registered Nurses or other medical staff based on member requests.
* Responds in a courteous and professional manner to general questions, using on-line databases to provide information to any member or other personnel calling the center.
* Identifies ways to improve quality of service to members and recommends steps used to accomplish these changes.
* Must perform all of the above duties while meeting established standard of performance for quality and productivity.
* Performs clerical duties which may include assigning new members a primary care physician, processing self-referral requests, calling patients and booking appointment for specialty appointments, calling members to cancel and reschedule appointments.
* Answer incoming calls.
* Determine type of appointment needed, determine appointment availability and schedule appointments.
* Prioritize members need and offer alternatives to member when appropriate.
* Determine if calls are urgent or emergent and refer to RNs as appropriate following established guidelines.
* Compose messages to providers or other medical staff based on member requests.
* Utilize databases to give information to members and other callers as requested.
* Refer members to eligibility department as appropriate.
* Notify members of appointment/scheduling changes by telephone as directed.
* Schedule, reschedule and/or verify appointments.
* Answer member inquiries.
* Contact appropriate department to obtain medical record numbers of new enrollees.
* Assist in resolving problems related to duplicate medical record numbers.
* Initiate change of physician requests.
* Initiate change forms for corrected medical record numbers.
* Verify and update member demographics.
* Perform on-line inquiry functions.
* Perform data retrieval of computerized data.
* Record and maintain activity logs.
* Clear paper jams and other routine maintenance of printers/copiers.
* Recommend procedure changes.
* Train and orient new or less experienced personnel.
* Serve as resource persons to co-workers and assist in problem solving.
* Perform other activities and duties as directed.
* Initiate telephone calls to physicians or other medical office staff when indicated to assist members.
* Assume other activities and responsibilities from time to time as directed.