Call Center Representative

It is our goal to provide the finest Orthopaedic care possible. This philosophy requires that all office staff and providers be sensitive and responsive to patients’ needs and preferences. The position is hourly, with workdays typically scheduled within a five-day workweek. Hours and days may vary based on operational needs, and all scheduling complies with applicable California wage-and-hour laws.

About the role

Under the supervision of the Call Center Manager, the Call Center Representative serves as the primary point of contact for patients and plays a key role in supporting access to care and efficient clinic operations. This position is responsible for providing professional, patient-centered service by assisting callers, coordinating communication between patients and healthcare teams, and facilitating access to services. The ideal candidate demonstrates strong customer service, organizational, and communication skills, with the ability to effectively manage multiple tasks in a fast-paced healthcare environment while maintaining confidentiality and professionalism.

Responsibilities

• Answer incoming telephone calls promptly and professionally.
• Obtain and update patient demographic information, including insurance coverage and copayments due at the time of service, to ensure accurate registration.
• Verify patient insurance eligibility using available verification tools and online resources.
• Obtain prior authorizations and required documentation through insurance portals, primary care providers, or other appropriate sources.
• Schedule, reschedule, cancel, and confirm patient appointments according to established scheduling guidelines.
• Review clinic notes and patient documentation to ensure accurate appointment scheduling.
• Scan and route patient documents to patient’s chart.
• Create and route action messages to the appropriate members of the patient care team, including MAs, Providers, Treatment Processors, and other departments as needed.
• Obtain email addresses to enable web/text communication with patients while educating them about the Patient Portal and promoting digital communication.
• Maintain productivity and performance metrics established by the department.
• Follow departmental workflows, policies, procedures, and quality standards.
• Provide a high level of customer service while demonstrating professional telephone etiquette and effective communication.
• Maintain patient confidentiality and comply with all HIPAA and organizational privacy requirements.
• Perform other duties and responsibilities as assigned by the Call Center Manager.

Relationships

The Call Center Representative reports directly to the Call Center Manager and communicates progress, reports, requests, concerns, problems, and expectations as needed. The role involves collegial and professional interactions with other office and clinical staff, as well as patients, medical groups, adjustors, nurse case managers, hospitals, and Primary Care Physicians. All communication should reflect a commitment to quality care and customer satisfaction, with unresolved conflicts reported to the Call Center Manager.

Performance Requirements

• Demonstrate excellent work habits, superior service, and the highest degree of professionalism.
• Employ positive communication skills and professional interpersonal abilities (tact, diplomacy, and respect) with patients and co-workers.
• Maintain a high degree of professionalism in appearance, communication, attendance, reliability, and teamwork.
• Exhibit strong organizational skills, including an orderly and neat work area and excellent time management, to ensure high productivity.
• Demonstrate a desire to succeed and a willingness to help others succeed.
• Comply with all Safety program elements, including adherence to policies, safe work practices, participation in training, use of protective equipment, and reporting safety concerns.
• Follow the code of conduct, displaying the highest level of ethics and integrity in actions, thoughts, and conduct as an employee of Arrowhead Orthopaedics.

Requirements

• High school diploma or equivalent required.
• Ability to type 40 words per minute.
• Previous call center, medical office, or healthcare customer service experience preferred.
• Knowledge of medical terminology.
• Proficiency with computers and common software; experience with electronic medical records (EMR).
• Strong verbal and written communication skills.
• Excellent customer service and interpersonal skills.
• Ability to multitask, prioritize, and work efficiently in a fast-paced environment; flexibility is essential.

Typical Physical Demands

• Requires sitting and walking, with daily occasional stooping, reaching, and bending.
• Occasional lifting up to thirty pounds.
• Hearing must be in the normal range for telephone and personal communication.
• Requires manual dexterity sufficient to operate keyboards and other office equipment.