Call Center Representative Clinical Triage

At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

The Call Center Representative-Clinical Triage position is responsible for conducting initial assessments, evaluating urgency of patient needs, providing medical advice, coordinating care with medical professionals, as well as scheduling and interacting with patients via telephone, face to face, email, and performs a range of duties which includes gathering required information in preparation for the patient’s on-site appointment.

Essential Functions

• Welcomes all patients and visitors by greeting patients and visitors in person or on the telephone.
• Handles all incoming telephone calls from patients, makes appointments in Athena, and answers general questions and inquiries.
• Uses Athena computer system to refer to existing patient information or set up new patients in Athena. Provides the patient with available timeslots to ensure full use of the physician timeslots.
• Maintains registration flow by efficiently moving patients through the process and readying them for clinical staff using Athena’s scheduling and EMR systems.
• Communicates all add-ons, delays, cancellations, and “no-shows” to clinic staff and makes note in the patient’s chart the date, time, and reason for any appointment cancellations/changes.
• Interacts with patients by answering questions, providing information, and keeping the Reception/Call Center area in order.
• Responsible for inputting very detailed information on the patient using a variety of computer screens. After completion of the call and input of the patient information, representative checks records verifying the details entered and adds any additional notes that may be necessary.
• Explains all current fees and patient financial responsibility and informs patient of payment required for existing balances due at or before next appointment.
• Provides information to callers on practice policies and procedures such as what is required following physician template, using proper encounter codes, in preparation for appointment (insurance, id, etc.).
• Schedules to ensure efficient patient flow based on predetermined appointment availability.
• Secures patient information and maintains patient confidentiality by completing and safeguarding medical records, completing diagnostic and procedure coding, and keeping patient information confidential.
• Follows up with patients when they are a no show for an appointment and may make calls to patients asking if they were satisfied with the service they received.
• Maintains general filing system and files appropriate correspondence electronically or manually.
• Receives, directs, and relays telephone and fax messages.
• Responds to calls efficiently. Does not put time saving before quality of service.
• Maintain inventories of supplies and provides a list of what is needed to the Team Leader.
• Must be able to cover Call Center desk as needed.
• Performs other general administrative tasks as directed by team lead.

Clinical Tirage Responsibilities and Duties

• Assess patient symptoms and needs over the phone.
• Provide medical advice based on clinical protocols and guidelines.
• Determine the urgency of patient conditions and recommend appropriate care levels.
• Document patient interactions and maintain accurate healthcare records.
• Coordinate with healthcare providers to ensure continuity of care.
• Educate patients on managing their health conditions at home.
• Monitor patient follow-ups and adjust care plans as necessary.
• Manage emergency calls and provide immediate guidance for critical situations.
• Utilize electronic health records and other healthcare technologies effectively.
• Participate in regular training and continuing education to stay updated with medical practices.

Knowledge/Skills/Abilities/Expectations

• Provides a positive and professional representation of the organization.
• Promotes a culture of safety for patients and employees through proper identification, reporting, documentation and prevention.
• Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of role or practice.
• Maintains compliance with organization's policies, as well as established practices, protocols and procedures of the position, department, and applicable professional standards.
• Complies with organizational and regulatory policies for handling confidential patient information.
• Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in the Vision, Mission, and Values of the organization.
• Adheres to professional standards, hospital policies and procedures, federal, state and local requirements and the TJC standards and or standards from other accrediting bodies.
• Reports practice feedback, barriers, progress, and results of improvement initiatives to VP/Director of CPMG, CPMG Practice Managers and/or Team Lead and appropriate workgroups.
• Recognizes and seeks to resolve negative situations that disrupt organizational/departmental harmony.
• Demonstrate empathic listening skills, potential problems and effectively participate in their resolution.
• Experience in interdisciplinary team function.
• Ability to manage conflict, stress and multiple simultaneous work demands in an effective, professional manner.
• Strong intellectual curiosity and ability to solve difficult problems with minimal supervision.
• This requires an ability to think creatively and develop and/or apply innovative practice solutions based on available resources.
• Demonstrates strong interpersonal communication skills, including, verbal, presentation, and written communication, and the ability to present results to varying audiences.
• EMR systems and Microsoft Office.
• Valid State of South Carolina Driver's license.

Education

• High school diploma or GED required.
• Associate degree preferred

Licenses/Certifications

• Must be a CMA, LPN or EMT and have clinical experience of at least 2 years.

Experience

• 1-3 years of clinical involvement required.
• Strong clinical assessment and critical thinking skills.
• Prior Call Center experience in a medical office.
• Experience with electronic scheduling system and electronic medical records (EMR).
• Ability to handle high-stress situations calmly and professionally.
• Knowledge of multi-line phone system.
• Proficient in computers and relevant software applications and practice management technology including electronic recordkeeping.
• Knowledge of customer service principles and practices.
• Demonstrated initiative and strong organizational skills.
• Exceptional interpersonal communication skills with a positive tone.
• Ability to work independently on assigned tasks as well as to accept direction on given assignments.
• Deals with confidential information and/or issues using discretion and judgment.