Customer Service Specialist

Hybrid • St. Anthony - St. Anthony, MN 55421

• Salary Range: $21.23 - $25.48 Hourly
• Job Shift: Day

Midwest Spine & Brain Institute is looking for a friendly and detail-oriented Customer Service Scheduler to be the welcoming voice of our team. In this role, you will connect directly with patients to address their needs, coordinate smooth appointments, and keep our operations running smoothly. If you thrive in a fast-paced environment and take pride in making a difference in our patient's life, we would love to have you on board.

Summary/objective

• Works in a medical clinic office environment.
• Involves frequent telephone and face-to-face contact with patients.
• Requires polite, friendly, and helpful communication with all persons.
• Requires manual dexterity sufficient to operate a keyboard efficiently, telephone, copier, and such other office equipment as necessary.
• Performs complete and accurate work.
• Operates clinic switchboard, provides routine information, and directs calls to appropriate area.
• Serves as a liaison between patient and support staff.
• Supports insurance verification and prior authorization activities for high-tech imaging and injection procedures and coordinates communication among patients, providers, insurance payers, and outside facilities.

Essential functions

Professional Expectations

• Willingness to travel to and provide coverage at different clinical locations based on operational needs.
• Maintain a professional work environment at the front desk, including no personal cellphone or tablet use while on duty.
• Adhere to professional dress standards, including MSBI logo apparel or business casual attire
• Demonstrate professional, compassionate, and proactive patient interactions, including greeting patients promptly upon arrival and offering courteous farewell when they depart.
• Exhibit strong attention to detail when scheduling appointments, collecting patient notes, and entering insurance and demographic information.
• Ensure clear, accurate, and timely communication in appointment notes and when coordinating with other team members.
• Refrain from eating food at the front desk while patients are present.

Switchboard

• Answer calls professionally within 3 rings.
• Ask caller what their call is regarding to direct to appropriate individual or department according to our call routing guide.
• Transfer calls to staff voice mail when appropriate. Use ‘soft transfer’ method for highest level of customer service.
• All phone calls are returned within the same day or following business morning. Voice mails can be left with patients, but continued attempts should be made to assure direct communication occurs within 24 hours.
• Respond to emergency calls according to established procedures.
• Answer questions regarding patient appointments and general clinic information.
• Performs other duties as assigned.
• Communicate in a HIPAA compliant manner for all phone and voicemail interactions.

Reception

• Greet patients and other customers in a friendly and professional manner.
• Verify new patient demographic information and obtain electronic signatures as needed including co-pays as appropriate.
• Verify patient demographic and insurance information for accuracy and update records as needed within the Electronic Health Record (EHR). Scan insurance cards and supporting documentation as appropriate.
• If provider is more than 15 minutes behind, notify patients and offer alternatives for rescheduling if needed. Continue to update patients who are waiting.
• Maintain clean and orderly workspace, lobby, and refreshment area.
• Assist with the care and maintenance of department equipment and supplies.
• Maintain patient information in a confidential manner.
• Work collaboratively with all members of the team.
• Perform other duties as assigned.

Scheduling

• Schedule patient appointments in an accurate, efficient, and timely manner.
• Coordinate scheduling activities related to high-tech imaging and injection procedures in accordance with provider orders, payer requirements, and departmental workflows.
• Obtain and enter correct detailed patient demographic information into system.
• Initiate on-line new patient documentation process.
• Understand governmental and commercial insurance accepted by Midwest Spine & Brain Institute (MSBI) and others related to PSA Agreements.
• Provide a detailed explanation to patients of what to expect for their visit.
• Reschedule clinics within 48 hours or sooner if necessary.
• Schedule requested appointments within 24 hours of receipt.
• Notify (email) staff of add-ons, cancellations, and schedule changes.
• Run the Televox reminder calls daily and process cancellation and reschedules appropriately.
• Monitor and manage online chat inquiries from patients.
• Monitor and manage assigned electronic work queues, tasks, and messages within established departmental timeframes.
• Verify patient insurance information and identify authorization requirements prior to scheduled services.
• Initiate, submit, and manage prior authorization requests for high-tech imaging and injection procedures.
• Obtain, review, and submit required clinical documentation to support authorization requests.
• Monitor authorization status and follow up with insurance payers to obtain determinations and prevent delays in patient care.
• Respond to payer requests for additional information and coordinate with providers and clinical staff as needed.
• Communicate authorization approvals, denials, and status updates to patients, providers, staff, and outside facilities as appropriate.
• Coordinate next steps following authorization approval, including forwarding orders, authorization information, and supporting documentation to performing facilities.
• Document authorization activity, payer communications, and approval information accurately within designated systems.
• Escalate complex authorization issues, denials, or barriers to appropriate clinical or leadership staff.
• Coordinate with other departments when authorization requests fall outside the scope of this position.
• This position is responsible for authorizations related to high-tech imaging and injections. (Surgical procedure authorizations are managed by a separate department and are not within the scope of this position.)
• Performs other duties as assigned.

Access to PHI (protected health information) will be limited based on employee’s job duties and employees will be expected to follow established HIPAA privacy and security policies.

Qualifications

Competencies/Qualifications/Abilities/Work Styles

Qualification:

• Knowledge of regulatory and organizational policies and procedures to successfully promote the organization, such as HIPAA.
• Knowledge of common safety hazards and precautions, and use of personal protective equipment to establish a safe work environment.
• Knowledge of insurance verification processes, medical necessity requirements, and prior authorization workflows preferred.
• Skill in identifying problems and researching and recommending solutions.
• Ability to react calmly and effectively in stressful or emergency situations and communicate clearly.
• Expertise and appropriate skill set in establishing and maintaining effective working relationships with patients, medical staff, and other customers.
• Ability to understand, adapt and apply guidelines and procedures.
• Requires providing ideas and participating in the implementation of such ideas to improve quality and/or patient satisfaction, reduce costs or improve employee work life.

Work Style:

• Integrity. Honest and ethical behavior in all actions.
• Independence. Ability to work from a variety of locations with little supervision and the ability to get things done autonomously.
• Social Orientation. Ability to connect with others on the job. Ability to work with customers in a kind and professional manner.
• Concern for Others. Sensitivity to the needs of others.
• Adaptability/Flexibility. Open to change and variety of workload.
• Attention to Detail. Thorough and complete in activities and follow-up to determine successful tasks to repeat and others to change or remove.
• Dependability. Reliable, responsible, and dependable in fulfilling obligations of the job and interaction with others.
• Self-Control. Ability to maintain composure, keep emotions in check, even in difficult situations.
• Stress Tolerance. Ability to accept criticism to improve performance.
• Cooperation. Pleasant attitude with others.

Work environment

• Ability to drive own motor vehicle for visits to various sites
• Requires consistently good attendance.
• Requires ability to work successfully under supervision, with co-workers, providers, other professionals as well as community members.

Physical demands

• Work may require sitting, standing, and walking for extensive periods of time.
• Occasionally lifts and carries items weighing up to 15-20 pounds.

Travel required

• Flexibility required based on clinic needs.

Required education and experience

• High school diploma or GED certificate
• 2+ years customer service, scheduling, insurance verification, or prior authorization experience in a healthcare setting preferred.
• EPIC experience required.

Affirmative Action/EEO statement

Midwest Spine & Brain Institute (MSBI) is an equal employment and affirmative action employer. MSBI does not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability, genetic information, marital status, veteran status, sexual orientation, gender identity, creed, status with respect to public assistance, or other protected class status.

Other duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.