- Summary: The Access Care Representative’s primary responsibility is to provide efficient and professional customer service to patients, providers, coworkers and other stakeholders via phone, email, messages, or other channels
- This role involves answering inquiries, scheduling appointments, verifying information, and addressing concerns, all while maintaining confidentiality and adhering to healthcare regulations
- The Access Care Representative is also responsible for verifying eligibility for every patient prior to scheduling to determine coverage
- Customer service is a core competency for Access Care Representatives
- The Access Care Representative will greet and handle inquiries and appointments via telephone in a promptly and timely manner
- Addressing customer questions regarding appointments, billing, insurance, programs and other healthcare-related topics
- Scheduling, rescheduling, and confirming appointments based on patients’ needs and urgency
- Verifying Information: Gathering and verifying patient demographic and insurance details
- Maintain effective communication and working relationships with other employees, departments and patients
- Maintain attention to detail with every call, in order to schedule accurately while following the patient’s PCP and Care teams
- Addressing Complaints: Handling patient complaints and concerns professionally and empathetically
- Documentation: Maintaining accurate records of patient interactions and inquiries
- HIPAA Compliance: Ensuring adherence to HIPAA regulations to protect patient privacy
- System Proficiency: Utilizing call center software, electronic health records (PM & EHR), Phreesia and other relevant systems
- Communication Skills: Providing clear and concise information to patients, manager and other stakeholders
- Maintain effective communication skills with patients
- This includes listening skillfully and displaying a willingness and ability to acknowledge patient needs, expectations and values through the use of reflective listening and empathy conveyance
- Responds to patient needs in a way that is helpful and beyond expectation
- Answer telephones (includes scheduling appointments) and provide information on Clinic operations following La Maestra’s established Phone Call Etiquette
- Schedule appointments using the PCMH script
- Assign patients to a Primary Care Provider (see PSR Procedures and Protocols)
- Always maintain La Maestra’s Phone Call Etiquette (see PSR procedures and Protocols)
- When asking patients whether their visit is an emergency room follow-up, the ACR must:
- Ask whether their appointment is an ER follow up without the patient having to do so
- Inform the patient that their physician WILL NOT be able to give them the proper appointment without their emergency room records therefore the patient needs to be assisted by a Case Manager first to retrieve the records
- The process for getting the emergency room records is lengthy, resulting in an elongated wait time
- Check emails and department messages and take appropriate action (i.e. call back patient, schedule appointment, forwarding message information to intended recipient, etc.)
- Responsible for being familiar with the basic guidelines and standards of the government programs the Clinic is engaged in and patients’ use, in paying for services
- Become and remain familiar with common private insurance company basic guidelines and standards
- Maintain office supplies and reorder as necessary
- Other functions as directed by the Supervisor
- Follow up on the no show patients (the day appointment was missed)
Appointment Confirmations: Call patients to remind them of scheduled appointment, check in time, and what they need to bring (1 or 2 day prior to the appointment, this based on department)
- Responsible for assisting patients with linkages to clinic services and other community-based services as needed
- One third of receptionists’ performance includes patient satisfaction levels
Performance Appraisal will include the level of patient satisfaction, accuracy of appointment setting, patient intakes for and for registration of patients
