Customer Service Representative

Full Time
Farmington, NM
Posted Today
Job description
Love what you do; Love where you live
The Customer Service Representative is entrusted to provide excellent service and set a positive tone for every customer while serving as the liaison between patients and clinic staff, and demonstrating self-confidence, adaptability and personal initiative. The CSR coordinates the customer encounters and serves as the communication hub for the clinic, in an attentive, courteous and competent manner.
Position Summary:
  • The Customer Service Representative is entrusted to provide excellent service and set a positive tone for every customer while serving as the liaison between patients and clinic staff, and demonstrating self-confidence, adaptability and personal initiative. The CSR coordinates the customer encounters and serves as the communication hub for the clinic, in an attentive, courteous and competent manner.
Required Behaviors:
  • As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values.
These values are our culture, our identity as an organization. Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our
values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.
Required Qualifications:
Education:
High school diploma or GED
Knowledge and Skills
Articulate; good communication skills; good grammar and spelling
Good problem solving skills
Knowledge of computer keyboard operation
Medical Terminology course required within 90 days of employment
Preferred Qualifications:
  • Previous medical background
  • Previous receptionist, clerical and or secretarial experience preferred.
Duties and Responsibilities:
Each Clinic serves a unique purpose. Individual CSR positions include all or some of the following:
Customer Service
1) Establishes and maintains effective relationships with all internal and external customers, who may include patients, physicians, other healthcare providers, co-workers, vendors, and visitors
2) Communicates, face to face and by telephone, with internal and external customers in a professional and courteous manner
3) Maintains a positive attitude and remains calm under pressure, while working in a fast-paced environment
4) Focuses on continuous improvement to meet customer needs; supports new programs, ideas and processes
5) Maintains sensitivity to others and adjusts behavior accordingly
6) Recognizes the importance of teamwork and effectively participates in teamwork processes.
7) Presents a professional appearance and acts as a positive representative of the clinic
Patient Check In and Check Out
1) Enters data correctly and efficiently, including demographics and patient insurances
2) Maintains medical records, reports and files as required
3) Answers multiple phone lines with courtesy and efficiency; takes and distributes messages; properly refers calls to providers and other staff members
4) Collects balances due from patients, including co-pays, co-insurances and outstanding balances
5) Performs accurate accounting of daily deposits and verification of cash on hand
6) Generates daily reports and verifies the accuracy of the data reported
7) Discusses financial responsibility with patient and/or guarantor and sets up payment arrangements in accordance with SJRMC policies
8) Follows protocol for opening and closing clinic
Appointment Scheduling: Demonstrates competency in the Scheduling Module and performs scheduling as per physician-specific protocol
Insurance Verification: Verifies patient insurance coverage in accordance with clinic protocol and demonstrates
competencies in both manual and electronic verification methods
Billing Rejections: Processes billing rejections in a timely and accurate manner
Mail Processing: Processes mail each day in an accurate and timely manner
Charge Entry
1) Posts charges and/or payments timely and accurately
2) Works collaboratively with clinical staff to ensure appropriate CPT and ICD-9 coding for all patient encounters
3) Resolves coding issues with the clinical staff promptly
Referral and Authorization Management: Obtains referrals, pre-certifications and authorizations in a timely and accurate manner, following payer specific requirements; maintains accurate documentation
Medical Records
1) Demonstrates ability to properly prepare process and file Medical Records
2) Maintains filing system
3) Provides correspondence and Medical Records to appropriate parties in a timely manner; processes all requests for Medical Records in a timely manner and in accordance with clinic protocol
Scanning: Performs scanning duties in a timely and accurate manner
Additional Responsibilities
1) Complies with and is knowledgeable of organizational and departmental policies and procedures, including safety procedures and policies
2) Contributes to the care of the environment by maintaining work areas and assisting with housekeeping tasks as needed
3) Utilizes computer system as needed for information, data analysis, and to complete tasks
4) Maintains customer’s rights (confidentiality, privacy, safety, security and decision making)
5) Attends departmental meetings and other in-services and training sessions relative to job
6) Performs basic tasks in a timely manner with minimum guidance and supervision
7) Assure that appropriate levels of office supplies are maintained
8) Demonstrates willingness to work toward departmental and organizational goals and objectives; is committed to the successful operation of the clinic
Each employee is responsible for implementing SJRMC’s Service Standards into their daily work.
Safety Courtesy Effectiveness Stewardship
Other duties as assigned
Physical Demands and Environmental Work Conditions:
  • Must be able to lift greater than 50 pounds and push 0-300 pounds frequently.
  • Must be able to see with corrective eyewear and hear clearly with assistance
  • Must be able to sit and walk frequently or for long periods of time; must be able to stand, bend, squat, climb, kneel, and twist routinely.
  • Extensive computer keyboarding occurs daily
  • Special Demands:
o Sets limits when dealing with angry, hostile, or sometimes verbally or physically abusive patients and families in an attempt to ensure a safe, respectful environment that will support the delivery of care.
o Some exposure to disease may occur
o Effectively copes and strives for balance when caring for acutely ill patients and families.
  • Specific Clinic Requirements:
o Urgent Care: willing to work 12 hour shifts, weekends and holidays
o San Juan Pediatrics: willing to work evening and Saturday shifts as assigned

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