Representative

Cumberland, RI

Post Date: 06/13/2017 Job ID: 22293 Category: Pharmacy

Training Schedule:
  • Mon- Fri 10am 6: 30pm

Work schedule:
  • 1pm - 9: 30pm during the week and noon 8: 30PM on the weekend day.
  • A weekend shift will be assigned weekly.
  • Patient Support Call Center is open all holidays except Christmas.
  • The department is open on all holidays except Christmas, so workers may be scheduled to work on a holiday.

Job Description:
  • As a Patient Support Specialist, you will work to resolve patient billing and insurance inquiries, as well as respond to patient inquires related to visits, treatments and services.

Responsibilities:
  • You will be responsible for answering incoming calls related to visits, patient billing statements, issues related to possible customer reimbursements, resolving patient payment concerns related to claims, and other general inquiries.
  • You will be responsible for providing concise medical and prescription information in accordance with HIPAA compliance requirements, including but not limited to recent visits, follow up inquiries, and medical records.
  • Additionally, you will work with other areas to obtain the necessary information to resolve patient concerns, insurance billing issues, and all service related inquires while ensuring the utmost level of customer satisfaction in accordance to values.
  • The Patient Support Specialist is responsible for providing concise patient and prescription information in accordance with HIPAA requirements via various sources.
  • This position maintains and supports the integrity of the Privacy Office to ensure HIPAA compliance when providing Protected Health Information.
  • Additionally, the person in this role provides support to Compliance and Persistency Programs.
  • Consult with patients in accordance with guidelines and state rules with direction from RN.
  • Provide patients with support on medication reactions.
  • Inform patients of strep test results or other documented findings in their records as requested.
  • Assist patients with general information as required.
  • Call patients back in timely manner.
  • Initiate patient concern process, data entry, and appropriate follow up via electronic and phone.
  • Print and mail visit summaries to Primary Care Providers (PCP s) that were unable to be faxed.
  • Triage patient symptoms for acuity and recognize when clinically appropriate to refer callers to other facilities such as Specialist, Urgent Care, or Emergency Rooms.
  • Report critical clinical patient information to high level practitioners.
  • Ascertain what patients are within the scope of practitioners and if not provide alternative suggestions.
  • Interpret and report value parameters of lab results to patients and practitioners.
  • Understand and follow all regulations and standards concerning protected healthcare information and HIPAA.
  • Provide quality assurance by reporting practices that are out of scope to District Managers of Operations.
  • Educate patients about their current diagnosis and proper follow up care.

Experience:
  • Inbound call center experience in a high-volume or fast-paced customer service setting.
  • Healthcare billing experience and experience explaining coverage to patients is a plus.
  • Knowledge of medical terminology and experience with electronic medical records and data entry also a plus.

Required Qualifications:
  • 1+ years of customer service experience required.
  • 1+ years using Microsoft Word, Excel, and Outlook in a professional or academic setting.

Education:
  • High School diploma or GED.

A-Line Staffing Solutions

877-782-3334

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