Patient Services Senior Lead

Job Description

Job Description

Summary

The Lead Patient Services Representative provides customer service to the company’s Medicare and Medicaid members to ensure patient satisfaction.

Duties and Responsibilities

1. Answer telephone calls in a timely and politely manner, preferably within three rings.
2. Make follow up calls regarding PCP appointments.
3. Ensure that reminder calls are made.
4. Assist with new PCP appointments if needed.
5. Call patients regarding missed appointments in order to improve services and customer experience.
6. Produce No Shows Report and submit to the Director of Patient Services which will be provided to upper management.
7. Make welcome call to inquire about the level of satisfaction with CMG’s services and current health plan.
8. Assist in anything patients require – from checking enrollment status to making PCP appointments.
9. Help clear any lack of information or follow up by the Broker.
10. Ensure that a tour of the center was given at the time of enrollment.
11. Produce Daily Reports regarding the progress of the call sessions.
12. Check of status of PCP appointment.

Qualifications

Education/Experience:

1. Must have High school diploma or equivalent.
2. Prior experience in customer service and/or clinical setting.
3. MS Office programs experience.

Skills:

1. Use relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
2. Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines and standard accepted practices
3. Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
4. Ability to work with individuals within and outside the organization, in professional and courteous manner.
5. Must develop constructive and cooperative working relationships with others.
6. Understand written sentences and paragraphs in work related documents.
7. Strong ability to use independent judgment and initiative.
8. Organized and able to manage competing priorities.
9. Resourcefulness in problem solving.
10. Actively look for ways to help people.
11. Strong written and verbal communications skills.
12. Knowledge of medical terminology.
13. Must be extremely detail oriented.
14. Strong organizational and interpersonal skills.
15. Knowledge of EHR preferred.
16. Bilingual skills preferred (English/Spanish or English/Creole).
17. Must develop constructive and cooperative working relationships with others.