Call Center Representative

About the Role

The Call Center Representative operates a multiline/ACD telephone system to answer a high volume of inbound patient calls across all UCHC clinic sites in a prompt, courteous, and professional manner. This role serves as a centralized point of contact for scheduling, patient inquiries, insurance verification, and general information, ensuring patients are connected to the appropriate care team, service, or resource.

Responsibilities

• Answers a high volume of inbound calls through the multiline/ACD call center telephone system, screening and directing calls and messages to the appropriate department, clinic site, or provider.
• Documents phone encounters, messages, and call outcomes in the electronic health record (EHR) or call center system in accordance with organizational documentation standards.
• Schedules, reschedules, and cancels patient appointments across all clinic sites and departments according to established scheduling protocols and provider templates.
• Verifies medical insurance eligibility and benefits (HMO, PPO, Medicare, Medi-Cal, and other payors) prior to or during scheduling.
• Acts as a patient relations representative by answering patient inquiries within the limits of their knowledge and UCHC policies and procedures, escalating complex or sensitive issues as needed.
• Retrieves and responds to messages from the after-hours answering service and coordinates timely handoff of urgent messages to clinical staff.
• Offers information on available government assistance programs and the sliding fee scale to patients as needed.
• Follows HIPAA confidentiality and security rules when providing patient information over the phone.
• Answers questions about the organization and provides callers with accurate information about UCHC services, locations, hours, and directions.
• Meets established call center performance standards, including call quality, average handle time, and call volume/productivity metrics.
• Escalates complex, clinical, or urgent calls to the appropriate supervisor, nurse triage line, or department.
• Participates in ongoing training on scheduling systems, EHR, and call center software and technology.
• Performs other tasks as deemed reasonable by the Call Center Supervisor.

Requirements

• High school diploma or equivalent required.
• 1+ year of call center, customer service, or medical office/scheduling experience preferred; experience in a healthcare or FQHC setting strongly preferred.
• Experience with multiline phone systems, ACD/call center software, and electronic health record (EHR) or practice management scheduling systems preferred.
• Knowledge of medical terminology and insurance verification (HMO, PPO, Medicare, Medi-Cal) preferred.
• Ability to type accurately and navigate multiple computer systems simultaneously while speaking with callers.

Skills

• Excellent verbal and written communication
• Active listening
• Service orientation
• Critical thinking
• Social perceptiveness
• Strong customer service skills; ability to remain calm and professional under high call volume
• Ability to multitask across phone, scheduling, and documentation systems
• Attention to detail and accuracy in documentation
• Bilingual-English/Spanish required

Physical Requirements

• Occasional light lifting up to 25 pounds, and some bending, stooping, or squatting.
• Considerable walking may be involved.
• Ability to sit or stand for extended periods of time.
• Flexibility to work in multiple locations throughout the week.
• Finger dexterity and hand coordination required.
• Specific vision abilities required: close vision, distance vision, ability to adjust or focus.

Work Environment

• Exposure to adverse conditions, extreme heat, cold, wet and/or humid conditions.
• Exposure to moving mechanical parts, fumes, airborne particles, toxic or caustic chemicals, outside weather conditions, and possible risk of electrical shock.
• Exposure to high, precarious places, explosives, radiation, and vibration.
• Protective clothing or equipment may be required, including gloves, helmets, steel-toed boots, and protective eyewear.
• The noise level in the work environment is usually high.