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Presbyterian Healthcare Services · 1 day ago

Scheduling Customer Service Representative-PEH

Presbyterian Espanola Hospital

Full-time

Onsite

Entry Level

$15.64/hr - $22.56/hr

1+ years exp

Presbyterian Healthcare Services is a not-for-profit healthcare system dedicated to improving the health of patients and communities in New Mexico. They are seeking a Scheduling Customer Service Representative who will provide customer service for patients regarding scheduling appointments, referrals, and maintaining patient demographics, ensuring excellence in service delivery.

AssociationHealth Care

H1B Sponsor Likely

Responsibilities

Responsible for providing customer service for patients in regard to the triage of patients, scheduling appointments, referrals, messaging, and maintaining patient demographics

Respond to incoming calls routed through skill-based technology to meet quality standards and performance measurements. Is ready to take calls at the scheduled time, and spends the appropriate amount of time taking calls throughout their shift to resolve contacts on initial encounter. Conducts outbound calls as required and meets established quality/quantity guidelines supporting PHS/PHP/PMG initiatives and/or programs

Develop and maintain positive customer or partner relationships. Acts as member/patient advocate in dealing with practitioners, employer groups, and brokers. Maintains prescribed standards of quality in all research, customer and partner contacts/service functions and promotes customer satisfaction/loyalty through quality contact and timeliness of responses, achieves quality audit results as required

Assists in the development of documentation of process and procedures into functional process improvements to enhance overall level of service to our customers and partners. Uses the Improvement model, identifies patterns in call inquiries/grievances, conducts root cause analysis in resubmitted and adjusted claims and reports to management team

Researches inquiries/special projects as requested and responds to customer, partner or other PHS/PHP business units to ensure accuracy of benefit interpretation with results of research and resolution and within required timelines. Responses to customer or partners to be done using Microsoft Word, Excel or similar databases when appropriate. Uses available documentation such as D.A.R.T., Provider Manual, Pres Online, and Policies and Procedures to analyze and provide accurate and consistent information and benefit interpretation

Participates as an effective and active team member both individually and in a team environment. Participates in a value-added manner as a team member to internal teams as well as other process improvement teams (i.e. QCC) and initiatives

Record all calls, mail, email, faxes, walk-in encounters, etc. in appropriate databases to provide meaningful, accurate data for analysis and reporting

Assist in coordinating (when necessary) meetings with customers or partners for training, contracting, and reporting

Coordinates the encounter or episode process for the customer/patient including scheduling, registration, co-pay collection, financial arrangements, charge posting, and reconciliation of monies collected

Qualification

Call center experienceClaims processingReimbursement methodologiesCRM knowledgeEPIC knowledgeTyping skillsEffective communicationOrganizational skillsTeam collaboration

Required

High school diploma plus one to three years office/business experience

Call center experience preferred and/or claims processing experience preferably in managed care with possible enrollment experience

Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, physician office staff

Written communication skills as well as business writing and presentation skills are required

Requires strong organizational skills

Ability to create, sort and analyze reports (Excel, Access, etc) and system processes

A thorough knowledge of reimbursement methodologies i.e. DRG, Relative Value Systems, Per Diem, Fee schedule, Capitation, etc

Some knowledge of risk sharing programs helpful

Some knowledge of CRM and EPIC as well as any other databases that may be used PHS Enterprise wide

Demonstrated ability to function effectively as a team member

Requires ability to retain plan details and basic medical terminology

Must be able to work cooperatively with other employees and function under pressure

Demonstrated ability to sustain quality standards

Ability to type 30 wpm with 90% accuracy

Benefits

Medical

Dental

Vision

Short-term and long-term disability

Group term life insurance

Other optional voluntary benefits

Employee Wellness rewards program

Company

Presbyterian Healthcare Services

Glassdoor3.6

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities they serve.

Founded in 1908

Clovis, New Mexico, USA

10001+ employees

http://www.phs.org

H1B Sponsorship

Presbyterian Healthcare Services has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (90)

2024 (86)

2023 (85)

2022 (93)

2021 (86)

2020 (76)