PACT Representative I

Responsibilities

• Uses facility/provider information and established policies and procedures to seamlessly link the patient experience between PACT and the practice site.
• Uses resources and critical thinking skills to assist inbound callers.
• Makes outbound calls when required or when follow up is deemed necessary.
• Recognizes complex problems and questions and escalates for resolution when needed.
• Performs basic technical troubleshooting in connection to online applications, systems, or access as requested to resolve issues.
• Schedules patient appointments and coordinates cancellations, reschedules, and additions to schedules.
• Obtains demographic and insurance information and verifies insurance coverage.
• Ensures insurance and patient information obtained is complete and accurate, updating information if necessary, applying acquired knowledge of government and third-party payer requirements.
• Completes all essential forms, obtains necessary information such as patient demographic and insurance information.
• Verifies and updates the medical record with patient information.
• Identifies emergent calls based on information provided by caller and department procedures.
• Follows the process for immediate transfer to Registered Nurse for triaging.
• Maintains competency in and adherence to guidelines for emergency situations and critical call handling.
• Determines the needs of patients calling the call center, resulting in routing patients for triage, scheduling, rescheduling, and canceling appointments, submitting medication refill requests for evaluation, and paging providers and facilities as appropriate.
• Provides customer service per established departmental standards as measured by patients on post-call survey.
• Asks clarifying questions, presents options or solutions, and understands the level of complexity of the call, escalating only those situations necessary for resolution.
• Assists with organizational marketing efforts by providing associated information and referral to customer, while maintaining appropriate records for documentation.
• Conducts regular reporting and updating of the provider and marketing databases.
• Performs additional duties based on department needs.
• Maintains knowledge and efficient utilization of all information systems utilized by the department.

Requirements

• Licensure, Registration, and/or Certification: None required.
• Education: High School Graduate.
• Experience: Typically requires 0–1 year experience in a call center, healthcare, or other applicable customer service-related area.
• Physical Requirements and Working Conditions: Must have functional vision, touch, speech, and hearing. Required to sit most of the workday. Operates all equipment necessary to perform the job. Exposed to normal office environment and/or remote work environments.
• Residency: Must reside in AL, AK, AR, AZ, DE, FL, GA, IA, ID, IN, IL, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, or WY.

Skills

• Knowledge of customer service and ability to work with a variety of patients and patient situations.
• Ability to follow workflows while operating in a structured environment.
• Basic knowledge of medical terminology is helpful but not required.
• Basic understanding of computers and desktop software packages.
• Ability to work in a fast-paced environment, handling a variety of customer/patient needs.
• Basic multitasking and problem-solving skills, as well as organization and prioritization skills.
• Ability to use/manage a multiple-line telephone system.
• Demonstrated ability for analysis, logical thinking, accuracy, and concern for detail.
• Strong verbal communication skills and ability to interact with a diverse customer population.
• Ability to provide excellent customer service and follow up.
• Ability to communicate with customers/patients while researching and documenting the interaction on multiple systems.
• Ability to work with a variety of customers and actively listen to successfully determine the customer's needs.
• Ability to resolve customer issues.
• Ability to work a variety of hours based on departmental business needs.