Serve as the initial point of contact for incoming calls to the center, screen telephone calls, and assess the severity/acuity of each call in order to appropriately evaluate and route it.
Responsibilities:
ESSENTIAL FUNCTIONS:
Always demonstrate a positive, empathetic, and professional attitude toward customers. When patient needs are not met, acknowledge concerns and work toward resolving complaints. Recognize that patient safety is a top priority.
Provide information and services related to coverage determination, service authorization (or denial), and linkage to resources, services, and support systems.
Answer all telephone calls using the approved telephone answering script.
Assess each call for a potential crisis before placing any caller on hold.
Identify and refer callers to appropriate community resources.
Observe and adhere to all HIPAA and Recipient Rights policies and procedures.
Provide consumer-focused, professional, and compassionate service.
Document incoming telephone calls and collect demographic information for all callers before making referrals or transfers.
Perform warm transfers for individuals requiring a clinical assessment/screening to the center's clinicians.
Ensure that all aspects of the enrollment and re-enrollment processes are completed. This includes answering inquiries, verifying consumer residency, and assigning clients as needed.
Provide consumers with accurate information regarding grievances, appeals, and local dispute resolution processes associated with their specific benefit plan.
Conduct follow-up calls and customer satisfaction calls.
OTHER FUNCTIONS:
Perform other functions and tasks as assigned.
Qualifications:
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
Ideally, possess college credits or a completed degree in Psychology or Social Work.
Availability to work rotating shifts.
Excellent communication and interpersonal skills.
Numbers & Facts
Location
Rio Piedras
Skills
Call Centersunmatched
Clinical Assessmentunmatched
Communication Skillsunmatched
Compensation and Benefitsunmatched
Customer Relationsunmatched
Customer Satisfactionunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Interpersonal Skillsunmatched
Resolve Customer Issuesunmatched
Scripting (Scripting Languages)unmatched
Telephone Skillsunmatched
🎯
Be found by employers
5,500+ employers search our resume database daily. Add yours to get found by recruiters looking for candidates like you.
Level up your application
Professional resume templates
Browse dozens of recruiter approved resume templates, layouts and formats. Choose your favorite and make it your own in minutes.