Job Abstract

This position provides high level member assistance by scheduling various appointments requested, transferring calls appropriately, composing messages, and providing general information.

• Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.
• Operates in a high volume, highly structured call center environment by responding to incoming calls.
• Determines the type of appointment requested or needed, reviews scheduling mix of various physicians/providers, and them makes appointment utilizing appropriate guidelines.
• Prioritizes member needs and offers alternatives to members when appropriate.
• Utilizes superior customer service skills to provide service to members when diffusing difficult member encounters.
• Uses tact and diplomacy in handling difficult interactions with members.
• Determine if calls are urgent or emergent by listening to the member, following established guidelines, and then transferring the call to a Registered Nurse when appropriate.
• Composes messages for physician/providers, Registered Nurses or other medical staff based on member requests.
• Responds in a courteous and professional manner to general questions, using on-line databases to provide information to any member or other personnel calling the center.
• Identifies ways to improve quality of service to members and recommends steps used to accomplish these changes.
• Must perform all of the above duties while meeting established standard of performance for quality and productivity.
• Performs clerical duties which may include assigning new members a primary care physician, processing self-referral requests, calling patients and booking appointment for specialty appointments, calling members to cancel and reschedule appointments.
• Answer incoming calls.
• Determine type of appointment needed, determine appointment availability and schedule appointments.
• Prioritize members need and offer alternatives to member when appropriate.
• Determine if calls are urgent or emergent and refer to RNs as appropriate following established guidelines.
• Compose messages to providers or other medical staff based on member requests.
• Utilize databases to give information to members and other callers as requested.
• Refer members to eligibility department as appropriate.
• Notify members of appointment/scheduling changes by telephone as directed.
• Schedule, reschedule and/or verify appointments.
• Answer member inquiries.
• Contact appropriate department to obtain medical record numbers of new enrollees.
• Assist in resolving problems related to duplicate medical record numbers.
• Initiate change of physician requests.
• Initiate change forms for corrected medical record numbers.
• Verify and update member demographics.
• Perform on-line inquiry functions.
• Perform data retrieval of computerized data.
• Record and maintain activity logs.
• Clear paper jams and other routine maintenance of printers/copiers.
• Recommend procedure changes.
• Train and orient new or less experienced personnel.
• Serve as resource persons to co-workers and assist in problem solving.
• Perform other activities and duties as directed.
• Initiate telephone calls to physicians or other medical office staff when indicated to assist members.
• Assume other activities and responsibilities from time to time as directed.