Job Description - Call Center Representative

Job Title: Call Center Representative


Reports To: Supervisor, Call Center


Job Summary: Confirms patient appointments and verifies patient insurance and demographic information.



Qualifications and Requirements:


The requirements listed below are representative of the knowledge, skill, and/or ability required. Job duties may be modified at any time based on business needs.



Essential Job Duties:



  • Answers phone calls expediently and refers inquiries to the appropriate parties as needed.

  • Schedules and confirms patient appointments over the phone.

  • Explains health center procedures to patients.

  • Verifies medical insurance coverage and eligibility and expires any insurances that are not active.

  • Verifies dental insurance coverage and eligibility, deductible, and maximum coverage.

  • Informs patients of account balances and correct billing amounts.

  • Notifies patients of insurance co-pays.

  • Verifies patient demographic information.

  • Ensures accuracy of information in telephone messages and deciphers the correct amount to charge self-pay or sliding fee schedule patients.

  • Takes payments over the phone.



  • Provides referral status information to patients.

  • Working assigned weekends as required.

  • Other duties as assigned.



Required Minimum Qualifications - Education, Experience, Certificates & Licenses:



  • High School Diploma or GED.

  • Three to six months customer service experience.



Preferred Qualifications – Education, Experience Certificates & Licenses:



  • One year of experience in a medical setting providing office support preferred.



Required Language Skills:



  • Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.

  • Bilingual in English and Spanish may be required based on current staffing patterns, patient population, and/or duty assignment.



Physical Requirements:



  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.

  • Ability to continuously remain in a stationary position.

  • Ability to occasionally move about inside the workplace to access files, office machinery, etc.

  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computers, telephone, and other office machinery.

  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.

  • Ability to discern the nature of sounds at a normal spoken volume.



Other Required Knowledge, Skills, and Abilities:



  • Ability to add, subtract, multiply, and divide in all measure, using whole numbers, common fractions, and decimals.

  • Ability to gather data in an organized fashion from varied sources.

  • Ability to take direction and perform assignments accordingly.

  • Knowledge of prepaid health plans preferred.

  • Knowledge of HIPAA and Corporate Compliance rules and regulations.

  • Computer literacy required.

  • Knowledge of Electronic Health Records preferred.

  • Ability to provide excellent customer service by mail, telephone, and in-person.

  • Ability to prioritize and plan work activities, use time efficiently and develop realistic action plans.

  • Ability to display a positive attitude towards patients, providers, supervisors, and other staff.



Work Environment & Conditions:



  • Work environment is typical of an administrative office setting with no substantial exposure to adverse environmental conditions.

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