Job Description

Job Title:                       Call Center Representative

Reports To:                   Call Center Supervisor

Job Summary:              Confirms patient appointments and verifies patient insurance and demographic information.                                                                                                                                                                       

Qualifications and Requirements:

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  This job description in no way implies that these are the only duties to be performed and may be modified, interpreted, and/or applied in any way, as necessary.  Maintaining regular and punctual attendance is required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

Essential Job Duties:

  • Answers phone calls expediently and refers inquiries to the appropriate parties as needed.
  • Schedules and confirms patient appointments over the phone.
  • Explains health center procedures to patients.
  • Verifies medical insurance coverage and eligibility and expires any insurances that are not active.
  • Verifies dental insurance coverage and eligibility, deductible, and maximum coverage.
  • Informs patients of account balances and correct billing amounts.
  • Notifies patients of insurance co-pays.
  • Verifies patient demographic information.
  • Ensures accuracy of information in telephone messages and deciphers the correct amount to charge self-pay or sliding fee schedule patients.
  • Takes payments over the phone.
  • Provides referral status information to patients.
  • Working assigned weekends is required. 

Required Education, Experience, Certificates & Licenses:

  • High School Diploma or GED.
  • At least six months of experience in a medical setting providing office support preferred.
  • Any combination of experience that provides the necessary combination of skills and sensitivity.
  • Valid Fingerprint Clearance Card. 

Required Language Skills:

  • Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.
  • Bilingual in English and Spanish may be required based on current staffing patterns, patient population, and/or duty assignment. 

Physical Requirements:

  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
  • Ability to continuously remain in a stationary position.
  • Ability to occasionally move about inside the workplace to access files, office machinery, etc.
  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
  • Ability to discern the nature of sounds at a normal spoken volume.

Other Required Knowledge, Skills, and Abilities:

  • Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions, and decimals.
  • Ability to gather data in an organized fashion from varied sources.
  • Ability to take direction and perform assignments accordingly.
  • Knowledge of prepaid health plans preferred.
  • Knowledge of HIPAA and Corporate Compliance rules and regulations.
  • Computer literacy required.
  • Knowledge of Electronic Health Records preferred.
  • Ability to provide excellent customer service by mail, telephone, and in-person.
  • Ability to prioritize and plan work activities, use time efficiently and develop realistic action plans.
  • Ability to display a positive attitude towards patients, providers, supervisors, and other staff. 

Work Environment & Conditions:

  • Work environment is typical of an administrative office setting with no substantial exposure to adverse environmental conditions.