Description:

Essential Functions:
– Upholds Kaiser Permanente’s 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 a mix of various physicians/providers, and then makes appointments 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 physicians/providers, Registered Nurses, or other medical staff based on member requests.

– Uses online databases to provide information to any member or other employees phoning the center, responding to general inquiries in a polite and professional manner.
– Identifies ways to enhance the caliber of service provided to members and suggests actions taken to bring about these changes.
– Must carry out all aforementioned tasks while upholding specified productivity and quality standards.

– Carries out clerical tasks, such as assigning new members to a primary care physician, handling self-referral requests, calling patients to make specialized appointment bookings, and calling members to reschedule and cancel appointment times.
Principal Job Responsibilities and Skills
– Respond to incoming calls.
– Determine the type of appointment required, check the availability of appointments, and schedule appointments.
– Give the member’s needs priority and, where necessary, present alternatives.

– Determine the urgency or emergent nature of calls and, in accordance with established protocols, send patients to registered nurses.
– Write letters to doctors or other medical personnel in response to requests from members.
– Use databases to provide members and other callers with information as needed.
– As necessary, refer members to the eligibility department.

– Notify members of appointment/scheduling changes by telephone as directed.
– Schedule, reschedule, and/or verify appointments.
– Answer member inquiries.
– Contact the 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 online 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.