The Customer Service Specialist II serves our patients, members, and providers.
Responsible for answering phone calls and scheduling patient appointments.
Triages phone calls as necessary.
May conduct patient/member pre-certification to ensure coverage for appointments and medical care.
With the assistance of data and technology, they function as a liaison and ensures a high value and personalized experience.
For Hoag Clinic: Member Advocate II
Member Advocate Level II develops a specialized expertise in a specific domain (Health Plan benefits, Provider Disputes, Professional chat etiquette guidelines, etc.).
The Level II advocate has a high proficiency to address complex issues with claims and referrals.
The Level II advocate will also perform outreach calls to assist with wellness activities.
For Revenue Cycle: CPS Specialist II
The Level II effectively handles 40+ transactions per day for multiple departments with minimal or no error.
Understands and performs competently all functions of the FAX, Work-lists and HIE duties.
Schedules and handles calls, concerns and procedures of an increasing complexity, including different departments for radiology sleep, and new departments who become part of the CPS department.
The expectation of Level II meets all requirements for excellent customer service by maintaining a high service patient and physician satisfaction rating.
Schedulers in this level can mentor staff and work independently in multiple departments and modalities with minimal or no supervision.
Qualifications
Education and Experience
For Member Advocate II – Hoag Clinic
Associates degree or higher OR obtaining a bachelor’s degree in healthcare related field OR certified medical assistant OR Licensed Vocational Nurse OR other professional clinical certification
3 years of customer service experience; 2 years of experience within a call center or healthcare setting with direct patient interaction
Bachelor’s degree or obtaining a bachelor’s degree in healthcare related field preferred
Previous work experience working as a care coordinator, member advocate, or health care unit coordinator preferred
Bilingual skills preferred
For Patient Scheduler II – Revenue Cycle
High School Diploma or equivalent
Complete 1 year of employment in Access Department or Front Desk scheduling or customer service experience
Complete 1 year experience in scheduling at Hoag Hospital
Accuracy 98%, for registrations and appointments; Productivity exceeds 60 registrations or appointments per day; Completes appointments in RMS and Affinity and meets monthly collection goals
Background in billing, collections, insurance verification, coding, patient access or appointment scheduling preferred
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