GUEST EXPERIENCE NAVIGATOR – CALL CENTER – FULL TIME Full Time NEW

SUMMARY/OBJECTIVE

The Guest Experience Navigator-Call Center team member must possess excellent customer service skills as (s)he will work directly with our patients to ensure a delightful experience. The GEN must demonstrate mastery in all duties to schedule, reschedule, and/or cancel for multiple providers within various specialties or the pediatric department. The GEN works in a fast-paced, high-volume Call Center environment where they receive incoming calls and make outgoing calls to schedule or reschedule appointments. Additionally, the GEN schedules appointments based on physician referrals and arranges hospital follow-up appointments according to discharge or Emergency Room instructions. The GEN will also manage appointment scheduling, rescheduling, and cancellations via Patient Portal requests on the patient’s behalf. Strong interpersonal skills are essential for effective communication, including a clear speaking voice. The GEN greets callers warmly and provides general directions to and within our facilities. They must interact with an affirmative demeanor towards patients, visitors, and co-workers alike, consistently displaying a positive and professional image to create a favorable lasting impression.

Essential Functions

Scheduling Appointments and Insurance Verification:

• Must follow HIPAA privacy policy guidelines.
• Receives incoming and makes outgoing calls to schedule or reschedule appointments; handles phone calls, faxes, voice mail messages and emails in a professional and timely manner.
• Obtain and/or verify patient demographic information to include address and phone number; update information as applicable; avoid duplicate patients.
• Obtain and/or verify patient’s insurance utilizing current Insurance Grid to ensure we are contracted with patient’s insurance carrier. Verifies payment source is accurately entered with appropriate case built and attached (i.e.: liability, work comp, agency grants, employer, or legal).
• If insurance is an HMO or requires an authorization (sometimes referred to as a “referral”)—confirm this is in place when applicable. Master/Verify/Update to ensure appropriate payment source is accurate and case attached if appropriate (i.e., Liability, work comp, agency grants, employer, VA, legal).
• Mail questionnaires to patients or advise them to retrieve and complete questionnaire from their patient portal according to physician/provider protocol.
• Notifies and reschedules bumped patients in a timely manner.

Billing And Payment Collection

• Follows IDX Alert policy prior to scheduling appointment and appropriately documents appointment comments to reflect PFS collection amounts.
• Follow NOI grid for self pay patients.
• Advise patients to bring co-payment if applicable.

Requirements

Required Education and Experience: All related education and experience must be within the last five (5) years. High School graduate or GED equivalent.

Preferred Education and Experience: Prefer understanding of medical, insurance, and legal terminology. Prefer 1+ years’ customer service experience in related field. Prefer 1+ years’ experience in medical appointment scheduling. Prefer 1+ years’ experience in insurance verification. Prefer 1+ years’ experience in billing/payment processing.

Additional Eligibility qualifications: Must meet department standards for general abilities and typing tests; must have accurate keyboard skills. Must have knowledge of Windows-based computer applications. Must be detail oriented and able to access data from varied resources and programs. Must possess professional manner and appearance.