This position provides high level member assistance by scheduling various appointments requested, transferring calls appropriately, composing messages, and providing general information. 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 mix of various physicians/providers, and them makes appointment 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 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 quality of service to members and recommends steps used to accomplish these changes. • Must perform all of the above duties while meeting established standard 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 appointment for specialty appointments, calling members to cancel and reschedule appointments. Principle Job Duties and Skills: • Answer incoming calls. • Determine type of appointment needed, determine appointment availability and schedule appointments. • Prioritize member’s need and offer alternatives to member 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 eligibility department as appropriate. • Notify members of appointment/scheduling changes by telephone as directed. • Schedule, reschedule and/or verify appointments. • Answer member inquiries. • Contact 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 on-line 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 Qualifications Pay Grade: 13 Basic Qualifications: Experience • Minimum one (1) year of customer service experience in a service related industry, preferably health care. Education • High school diploma or equivalent. License, Certification, Registration N/A. Additional Requirements: • Effective telephone communication skills and excellent interpersonal skills. • Must obtain passing score on Customer Care Simulation assessment. • The Customer Care Simulation assessment score must be current within one (1) year (contact Local HR Office for testing). • Must be able to effectively communicate, verbally and in writing. • As part of applicant process, must take Proofreading Assessment for non KP employees only. Preferred Qualifications: • N/A. Notes: • This is an on-call position; schedule/days and hours may vary. • Must be available for a shift between the hours of 7:00 am – 9:00 pm Monday thru Friday and 8:00 am – 5:00 pm Saturday. • May travel (5%). |
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OVERVIEW
America’s leading not-for-profit health plan, Kaiser Permanente serves more than 9 million people from 37 hospitals and 611…
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