This position provides high-level member assistance by scheduling various appointments requested, transferring calls appropriately, composing messages, and providing general information.

– Composes messages for physician/providers, Registered Nurses or other medical staff based on member requests.
– Responds in a courteous and professional manner to general questions, using on-line databases to provide information to any member or other personnel calling the center.
– Identifies ways to improve the quality of service to members and recommends steps used to accomplish these changes.
– Must perform all of the above duties while meeting established standards of performance for quality and productivity.
– Performs clerical duties which may include assigning new members a primary care physician, processing self-referral requests, calling patients and booking an appointment for specialty appointments, and calling members to cancel and reschedule appointments.
– Principle Job Duties and Skills:
– Answer incoming calls.
– Determine the type of appointment needed, determine appointment availability, and schedule appointments.
– Prioritize members’ needs and offer alternatives to members when appropriate.
– Determine if calls are urgent or emergent and refer to RNs as appropriate following established guidelines.
– Compose messages to providers or other medical staff based on member requests.
– Utilize databases to give information to members and other callers as requested.
– Refer members to the eligibility department as appropriate.
– 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.