Job Title: Intake and Customer Service Specialist Job Status: Full-time Job Summary: Under general supervision, the Intake and Customer Service Specialist assures the accessibility of effective community services that empowers individuals and families to achieve an enhanced quality of life. They interact with customers by addressing inquiries and resolving client complaints. They provide a high level of customer service support and handles matters professionally and responsibly and administer medical billing tasks. Quality customized services, client care and satisfaction are the ultimate goal.
Essential Duties and Responsibilities: Welcome people to the department and programAnswer telephone calls, questions and service inquiries about servicesProvide a warm transfer with customer-centered service to ensure client makes the initial contact with funders and health plansProvide information on how to access services and rights processesAssist with resolution of local complaints, grievances, and appeals processesSurvey, track, trend, and report on member/provider experiencesProvide behavioral health, customer service, outreach, education, and training support.Maintain current listings of all providers, both organizations and practitioners, with whom the DWIHN/MCCMH or programs have contracts, the service they provide, languages they speak including American Sign Language, any specialty for which they are known and accommodations for individuals with a disabilityFollow up with appropriate staff and document results on the internal system and calendars, if applicableSchedule intake appointments with relevant program staffRecord customer information and outcomes and enter services on the appropriate internal system, highlighting all given resourcesExplain program requirements and any fees, if applicable, to clientsMaintain current knowledge regarding ACCESS programs and field of workRefer clients with possible well-being matters to internal resources when necessaryTrack referrals and enrollment status of clients, document outcome of the referral and enrollment, and provide support as appropriate, document barriers to enrollment, if anyProvide excellent internal/external customer services via telephone, e-mail, or face-to-face to assist customers with their eligibility and enrollment needs and answer questions or concerns regarding program processes and requirementsProvide an overview of all internal services and help refer and/or enroll the client to obtain the necessary service and encourage participationKeep current with trends and developments related to essential job competenciesProtect confidentiality of customers at all times and abide by HIPPA law and confidentiality policyFollow policies and procedures at all times and complete documentation in appropriate systemsAttend regular team meetings, and share any helpful/challenging/issuesAttend monthly staff meetings and all mandatory organization activitiesTake fax orders, phone calls, in person new clients' and schedule new program screenings and evaluationsProject positive, flexible attitude in attempting to meet Clients' scheduling needsPerform receptionist functions and assure that the telephone is answered, visitors/clients/patients are greeted, in a courteous, professional and timely mannerPerform registration functions and assure timely, efficient, and customer-friendly registration are metVerify and process program eligibility and benefits verification for all clientsAssist in resolving any client issues generated through contract account denialsVerify client insurance coverage and prepare EMR case with all demographic and benefits informationMay process insurance pre-authorizations for patients, if applicable, for programWork staff to resolve any issue to ensure timely filing and clean-claim requirementsMay enroll and inform patients and clients about insurance affordability through the local health exchanges and public insurance programs to encourage participationMay issue notices of hot jobs and in-demand trainings to clientsMay issue notices and revised fee agreements while compiling data and entering information for sliding scale fee reductionsMay pre-register clients for all disciplines before first appointment, preparing chart within EMROperate standard office equipment and use required software applicationsPerform other duties and responsibilities as assignedKnowledge, Skills and Abilities: Knowledge of:
Uninsured and underserved populationsCommercial and worker's compensation insuranceSkill in:
Critical thinking with the ability to effectively problem solve (e.g., able to determine if a client issue requires immediate provider attention if there are significant changes to the client history or other clinical issues that are presented)Strong customer service skillsStrong multi-tasking skillsOrganizational and time management skills to effectively juggle multiple priorities, time constraints and large volumes of workOperating standard office equipment and using required software applications for program area and other applications, including Microsoft OfficeAbility to:
Operate a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, Microsoft Word, Excel, Outlook, intranet and computer navigationMaster the rules of a number of complex public benefits programsEstablish positive relationships with associates, volunteers and third-party intermediariesBe highly organized with the ability to multi-task and adapt to changing prioritiesEstablish and meet deadlinesEvaluate each registration/admission and be alerted to potential problems, including pre-certification or financial assistance for the clientCommunicate effectively with both written and verbal forms, including proper phone etiquetteWork collaboratively in a team-oriented environment; courteous and friendly demeanorWork effectively with various levels of organizational members and diverse populations including ACCESS staff, clients, family members, insurance carriers, outside customers, vendors and couriersCross-train in other areas of practice in order to achieve smooth flow of all operationsExercise sound judgment and problem-solving skills, specifically as it relates to resolving billing and coding problemsHandle client and organizational information in a confidential mannerWork under minimal supervisionEducational/Previous Experience Requirements: Minimum Degree Required:High School or GEDAssociate degree preferredRequired Disciplines:Health Administration, Business Administration or related field approved by Human Resources~and~
For Workforce Development, at least 3-5 years previous workforce development experience in a funded program that includes enrolling into a funded program, intake, referral to services for training, supportive services and knowledge of program policies and system partners, or equivalent combination of education, experience and/or training approved by Human ResourcesFor Community Health & Research Center, at least 3-5 years previous experience including experience with medical insurance processing, Medicare, Medicaid, CCI edits, Medicare Functional Therapy Reporting and Therapy Cap requirements, local payer coding and billing guidelines as they pertain to physical, occupational, or speech therapy preferred or equivalent combination of education, experience and/or training approved by Human ResourcesLicenses/Certifications: Licenses/Certifications Required at Date of Hire: NoneWorking Conditions: Hours: Normal business hours, some additional hours may be required
Travel Required: Some local travel may be required
Working Environment: Climate controlled office
