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Kaiser Permanente · 1 day ago

Clinical Contact Center Specialty Representative

Denver, CO

Full-time

Onsite

Entry Level

2+ years exp

Kaiser Permanente is a healthcare organization seeking a Clinical Contact Center Specialty Representative. This role involves scheduling and documenting medical visits and procedures, coordinating care among various specialties, and providing information to members and patients to enhance their experience and ensure efficient scheduling.

Health CareHospitalMental HealthNon ProfitPersonal Health

Comp. & Benefits

Responsibilities

May be entitled to translation/bilingual, shift or other wage premiums as governed by the applicable collective bargaining agreement

Schedule and document for a variety of routine to complex medical visits/procedures for members/patients via inbound and outbound calls for Surgical and Medical Subspecialties as assigned

Transfer calls or message appropriate personnel/departments according to protocol

Asks patients exam-appropriate screening questions and documents information

Instruct and inform preparations, nature of examinations, reporting procedures, and other pertinent information to the member/patient within scope outlined and defined by department policy and guidelines

Provides scheduling decisions, which improve and maximize overall system efficiencies and increase appropriate utilization

Responsible for scheduling procedures including Preop evaluations and anesthesia for Gastroenterology OR slot/procedures as needed

Order prescriptions and other tests that pertain to scheduling that are required and approved by the physician/provider

Serves as a resource to internal and external customers for CT, MRI, and Nuclear Medicine information services

Consults with physicians, providers, designated health plan staff, and members/patients to coordinate outside referrals

Departments could include Endo, Interventional Radiology, Plastic Surgery, Rehab Services, Rheumatology, Urology, Wound Care, Vascular, General Surgery, Allergy, Pulmonology, Sleep Medicine, Head and Neck, Dermatology, Neurology, Orthopedics, Gastroenterology, Cardiology, Neurosurgery, Optometry, Ophthalmology, Radiology, and other subspecialities

Makes members/patients and their needs a primary focus of ones actions; develops and sustains productive member/patient relationships

This position, knows and complies with all Kaiser Permanente quality, safety, and emergency policies and procedures

Demonstrates quality and effectiveness in work habits and clinical practice in every interaction with patients, colleagues, providers, and leadership

Ensures patient safety in the preparation and provisioning of care related to but not limited to medications, procedures, infection prevention, fall prevention, including consistent use of two patient identifiers and procedural time outs

Reports safety hazards, accidents and incidents, and unsafe working conditions promptly

Appoints routine to complex schedules for multiple specialties

Acts as a liaison via inbound/outbound calls between Kaiser Permanente members/patients, Care Delivery teams, internal and external physicians/providers, and anesthesiologists, to coordinate care as needed

Makes complex scheduling decisions that maximize efficiency and utilization according to established guidelines

Schedules, for the entire region, CT, MRI, Nuclear Medicine, Mammography, Sonography, Fluoroscopy, Bone Mineral Densitometry, and Diagnostic Imaging examinations for Health Plan members, with the members themselves and with multi-disciplinary providers

Determines the probable length of the procedure

Coordinates the availability of the Technician, room and camera, and Radiologist availability with the availability and need of the patient

Schedules required/approved anesthesia for procedures per physician/provider direction

Schedules Pre-op evaluations in the Preop Evaluation Education Center (PEEC) or Primary Care

Schedules biopsies and coordinates schedule with recovery, pathology, the nurse, and radiologist

Schedules myelograms and arthrograms and coordinates back-to-back times for fluoroscopy and CT

Reviews the member/patient care history in appropriate Kaiser system

Order prescriptions and other tests that pertain to specialty scheduling that are required and approved by the physician/provider

Must be able to adapt and process new information daily as events arise and system changes are implemented that change approved booking procedures

Relays approved messages, test results, and patient care information per guidelines to members/patients within Scope of Employment (SOE)

Messages information or transfers calls to appropriate personnel if member/patient requests advice, an urgent/emergent appointment or according to established protocol

Gather information from the patient /provider regarding possible surgeries, medication, medical devices in place, or other conditions that could affect scheduling of appointment

Conduct chart review for optimal scheduling of appointment

Educate and inform patients on the appropriate preparation as to what to do and what to avoid, the type of clothing to wear and possible side effects

Provides information/resources for laboratory services within Kaiser Permanente and at our partner institutions

Provides co-pay information to the patients based on their selected benefit plan

Schedules interpreter for non-English speaking members or members that are hearing impaired

Documents third-Party Liability, Workmans Compensation, and Auto Accident procedures/requirements related to identification for the specialty appointment scheduling and billing process

May reschedule appointments and contact member/patient based on supervisor request

Utilizes web-based application to receive instructions from the Radiologists regarding recommendations and need for scheduling additional exams for patients; and to document actions and final resolution status

Confers and consults with physicians, providers, designated health plan staff (i.e.. nurses, radiology liaisons and technologists), and members/patients to coordinate outside referrals

Initiate outside referrals for CT, MRI and Nuclear Medicine

Determines when it is appropriate to refer out and assigns the appropriate vendor

May utilize chat function as a day-to-day resource

May coordinate scheduling of one or more back-to-back appointments with two or more departments

Serves as a liaison between the Radiology Department and all departments and providers requesting CT, MRI, and Nuclear Medicine examinations

Remains informed on new technologies and their implications for patients and the Radiology Department

Maintains proficiency in the use of the Radiology Information System, Health Connect, CMS, and current telephone techniques

Qualification

Healthcare scheduling experienceMedical terminology knowledgeComputer systems proficiencyCustomer service skillsHigh volume call managementAttention to detailEffective communicationProblem-solving skills

Required

Minimum of two (2) years of experience scheduling physicians/providers in a healthcare setting required

Minimum of one (1) year previous experience in managing high volume of inbound and outbound calls is required

High School Diploma OR General Education Diploma (GED) required

Successful completion of basic medical terminology course or experience using medical terminology

Previous experience using a computer terminal required. Must pass typing test of 35 WPM with 5% or less error rate

Ability to work effectively with providers, patients, support staff and other personnel to coordinate schedules which requires a high degree of accuracy and attention to detail

Proficient user of computer systems

Working knowledge of surgery scheduling computer applications

Excellent customer service skills required. Effective verbal, written, interpersonal and problem-solving skills essential

Demonstrated customer focus abilities and the ability to understand Kaiser Permanente customer needs