Working within the vision, mission and philosophy of the agency, the Customer Service Specialist is responsible for processing and completing internal and external referrals, acts as primary liaison between external agencies and internal agency departments and completes all required administrative paperwork and data entry for customer records. Coordinates all activities related to initial intake, level of care screening, insurance verification and payment coordination. Regularly interfaces face-... more details
Who We Are
Pacific Clinics is California's largest community-based nonprofit provider of behavioral and mental health services and support. Our team of more than 2,000 employees speak 22 languages and are dedicated to offering hope and unlocking the full potential of individuals and families through culturally responsive, trauma-informed, research-based services for individuals and families from birth to older adults.
Who We Serve
Pacific Clinics serves children, transitional age youth, families, adults, and older adults. We offer a full range of mental and behavioral health services, foster care and social services, housing, continuing adult education and early childhood education programs to Medi-Cal eligible individuals and families throughout Alameda, Contra Costa, Fresno, Kings, Los Angeles, Madera, Orange, Placer, Riverside, Sacramento, San Bernardino, San Francisco, Santa Clara, Solano, Stanislaus, Stockton, Tulare and Ventura Counties.
What We Offer
• Starting pay range is up to $27.16 per hour. Compensation may vary based on skills, experience, education, and location.
• We Offer Medical, Dental & Vision benefits, retirement options, Flex Spending, EAP, and more!
• Employee engagement and advocacy opportunities to advance our justice, equity, diversity, and inclusion agenda across our Agency and throughout the communities we serve.
JOB SUMMARY
Working within the vision, mission and philosophy of the agency, the Customer Service Specialist is responsible for processing and completing internal and external referrals, acts as primary liaison between external agencies and internal agency departments and completes all required administrative paperwork and data entry for customer records. Coordinates all activities related to initial intake, level of care screening, insurance verification and payment coordination. Regularly interfaces face-to-face and by telephone with customers as well as with all agency and County electronic systems connected to client care and billing.
RESPONSIBILITIES AND DUTIES
• Answers phones and obtains all information related to initial request for services, referral source, basic demographics, and insurance/payment responsibility
• Completes comprehensive phone screens and utilizes comprehensive knowledge of the Agency’s continuum of care to make initial referral recommendations
• Answers questions regarding service availability
• Ensures that non-English language needs are met to facilitate effective access
• Creates electronic record and/or documents in other logs or databases as indicated
• Triages services to other community resources if applicable
• Maintains all tracking systems
• For foster youth, obtain qualifying minute order. Also obtains other relevant court documents as needed.
• Verifies/clarifies insurance eligibility, co-pays, deductibles and enters into electronic record
• Coordinates with program manager, family, and billing re: payment issues
• Ensures that all initial and ongoing insurance authorization information is recorded in clinical record
• Liaison between all internal program departments regarding referral coordination
• Routinely maintains, verifies and confirms data entry accuracy and consistency between internal electronic records and all County systems
• Participates as member of team in QA/QI activities
• Prepares variety of reports as requested
• Works closely with Program Manager to continually build, improve, and refine Customer Services infrastructure
• Maintains expertise in agency-wide procedures
• To serve as back-up to any HIM and other Customer Services staff absences.
• Other duties as assigned to support specific agency/business need and/or enhancement of operations
JOB SPECIFIC COMPETENCIES
• Advanced skills in Microsoft Office (e.g., Word, Excel, Project Management, etc.)
• Attention to detail
• Conflict Resolution
• Documents Clearly and Accurately
• Encourages Customer Focus
• Time Management
• Strong communication skills
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION
• High school diploma or GED Required
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• High School diploma or GED with three (3) years related experience required or,
• AA degree with at least one (1) year of related experience preferred or,
• Bachelor of Arts/Bachelor of Science (B.A./B.S.) in Psychology, Social Work, Education, Developmental Disability or related field preferred
REQUIRED EXPERIENCE
• Communication and clinical skills relevant to intake services including: customer screening and triage, understanding of legal/ethical issues and risk management
• At least 1 year experience in community mental health, behavioral health, developmental disabilities, or social services setting
• High School diploma or GED with three (3) years related experience required or,
• AA degree with at least one (1) year of related experience preferred or,
PREFERRED QUALIFICATIONS
• Bachelor of Arts/Bachelor of Science (B.A./B.S.) in Psychology, Social Work, Education, Developmental Disability or related field preferred.
• Two (2) years of experience in medical, behavioral health, mental health, developmental disabilities or social services field
