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

Essential Functions:
- Upholds Kaiser Permanente's 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.
- Principle Job Duties and Skills:
- Answer incoming calls.
- Determine type of appointment needed, determine appointment availability and schedule appointments.
- Prioritize member's 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.

Pay Grade: 13
Basic Qualifications:
Experience
• One (1) year of customer service experience in a service related industry, preferably healthcare.
Education
• High school diploma or equivalent.
License, Certification, Registration
• N/A.
 
Additional Requirements:
• Effective telephone communication skills and excellent interpersonal skills.
• Must obtain passing score on Customer Care Simulation assessment.
• The Customer Care Simulation assessment score must be current within one (1) year (contact Local HR Office for testing).
• Must be able to effectively communicate, verbally and in writing, in English.
• Must complete Service Orientation Assessment.
• As part of applicant process, must take Proofreading Assessment for non KP employees only.
 

Preferred Qualifications:
• N/A

 

Notes:
• This is an on-call position, days and hours may vary.