Patient Care Navigator at Pediatric Associates

PRIMARY FUNCTION

Answer incoming calls from patients while delivering outstanding customer service with a strong focus on patient experience for medical appointments. Ensure service quality aligns with organizational mission, goals, and values.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This list may not include all of the duties that may be assigned.

1. Answer incoming calls with a professional, friendly, and patient-centered attitude.
2. Follow prepared scripts based on call type to ensure consistent service quality.
3. Register new patients by gathering pertinent information and entering it accurately into the system.
4. Verify insurance coverage and information with a focus on accuracy and clarity.
5. Set and manage patient appointments while ensuring optimal patient experience.
6. Document accurately and efficiently within all systems.
7. Document patient questions and messages for Clinicians following communication protocols.
8. Collect necessary information to support timely and accurate physician follow-up.
9. Complete referrals requested via phone for provider approval.
10. Provide product and service information in a clear and empathetic manner.
11. Research required information using available resources to resolve patient inquiries.
12. Communicate with offices as needed for patient care coordination.
13. Handle patient complaints professionally and offer appropriate solutions.
14. Meet established performance standards including quality assurance, productivity, and patient experience metrics.
15. Maintain outstanding attendance and schedule adherence.
16. Participate in required training sessions to remain updated on protocols.
17. Other duties may include outbound calls, copying, faxing, and similar tasks.

SUPERVISORY RESPONSIBILITIES

None

QUALIFICATIONS

EDUCATION: High School Diploma or equivalent

EXPERIENCE:

• Minimum two-year call center experience
• Strong previous customer service experience required with emphasis on patient experience.
• Knowledge of CRM, automated call distribution, IVR, and skill-based routing systems preferred.

LICENSURE / CERTIFICATION

None

KNOWLEDGE, SKILLS AND ABILITIES

• C2 English level required/Native (verbal and written).
• Strong verbal, written, and interpersonal communication skills with focus on empathy and patient experience.
• Ability to maintain outstanding attendance and consistent performance.
• Strong multi-tasking abilities while maintaining accuracy.
• Familiarity with contact recording systems.
• Proficient in Microsoft Office, Internet, Email, and PowerPoint.
• Ability to work effectively in a team environment.

TYPICAL WORKING CONDITIONS

• Non-patient facing.
• Must be Mexico based.
• Professional office environment with high call volumes.
• Requires ability to multi-task, communicate clearly, and perform data entry for extended periods.
• Prolonged sitting may be required.

OTHER PHYSICAL REQUIREMENTS

• Vision
• Sense of sound
• Sense of touch
• Manual Dexterity
• Operating Computer
• May rotate working in the office and remote/telework.

PERFORMANCE REQUIREMENTS

Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI (Protected Health Information) in accordance with organizational policy, Federal, State, and local regulations.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to be an accurate reflection of the general nature of level of the job.