About this role
PURPOSE STATEMENT:
Serve as the initial point of contact for incoming calls to the center, screen telephone calls, and assess the severity/acuity of each call in order to appropriately evaluate and route it.
ESSENTIAL FUNCTIONS:
• Always demonstrate a positive, empathetic, and professional attitude toward customers. When patient needs are not met, acknowledge concerns and work toward resolving complaints. Recognize that patient safety is a top priority. • Provide information and services related to coverage determination, service authorization (or denial), and linkage to resources, services, and support systems. • Answer all telephone calls using the approved telephone answering script. • Assess each call for a potential crisis before placing any caller on hold. • Identify and refer callers to appropriate community resources. • Observe and adhere to all HIPAA and Recipient Rights policies and procedures. • Provide consumer-focused, professional, and compassionate service. • Document incoming telephone calls and collect demographic information for all callers before making referrals or transfers. • Perform warm transfers for individuals requiring a clinical assessment/screening to the center's clinicians. • Ensure that all aspects of the enrollment and re-enrollment processes are completed. This includes answering inquiries, verifying consumer residency, and assigning clients as needed. • Provide consumers with accurate information regarding grievances, appeals, and local dispute resolution processes associated with their specific benefit plan. • Conduct follow-up calls and customer satisfaction calls. OTHER FUNCTIONS:
• Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
• Ideally, possess college credits or a completed degree in Psychology or Social Work. • Availability to work rotating shifts. • Excellent communication and interpersonal skills.