Major Responsibilities:Communicates verbally and in writing with patients and families regarding their concerns. Anticipates what information will be needed to address their concern. Identifies patient expectations and probes into the root of the concern. Resolves problems and prioritizes needs requiring in-depth knowledge of policies and procedures.Answers, and initiates telephone calls and meets with patients and visitors providing procedural information and answering inquires related to operational and substantive matters.Analyzes patient experience data, complaints or concerns for trends and events to support measurements and intervention planning. Incorporates data into clinical operations problem/diagnosis identification. Initiates, recommends and/or participates in the development of improvement plans that include interventions and learnings designed to enhance patient outcome and reduce organizational liability. Assesses data reflective of patient status to create action plans and provide appropriate follow-up based on department's policies and procedures.Documents patient concerns and complaints. May independently resolve the patient concern or will coordinate resolution by working closely with patients, caregivers and physicians. Integrates quality and safety in evaluating patient complaints in attaining expected outcomes. Ensures that operational leaders and risk management are informed of high exposure or risk cases.Compiles documentation, develops and presents recommended responses for quality review. Develops correspondence in response to patient concerns and complaints, anticipating committee findings. Correspondence may include collaborating with physicians to outline an expected plan of care for the patient and conditions necessary for continued care.Communicates and explains various basic to complex processes that affect patient care, such as billing, coding, medical practices, etc. Performs a variety of moderately complex word processing such as creating/drafting correspondence, memos, and documents from rough draft, under verbal instruction, or independently. Makes decisions on format and layout and edits for accuracy and consistency of data.Acts as a resource for caregivers and physicians who are encountering unique patient circumstances. Responds to staff requests for service recovery remuneration for patient issues/concerns, provides guidance, reviews situation and uses discretion to prepare proposal for quality review committee consideration and approval.
Licensure, Registration, and/or Certification Required:None Required.
Education Required:High School Graduate.
Experience Required:Typically requires 3 years of experience in customer service that includes experiences in complaint and conflict resolution, investigating and compiling concerns, and general health care processes and physician practice workflow.
Knowledge, Skills & Abilities Required:Demonstrates knowledge of complaint and conflict resolution, investigating and compiling concerns, and general health care processes and physician practice workflow.Excellent communication (oral and written) and interpersonal skills. Ability to work with a varied population of patients, staff, leadership and physicians.Proficient computer skills, including the use of Microsoft Office suite (Word, Excel, Access, etc.) or similar products.Excellent conflict management skills including the ability to diffuse hostile or tense situations.Excellent problem solving, listening, customer service and organizational skills.Ability to independently develop correspondence, and independently problem solve.Ability to assess and interpret data, create action plans, and provide follow-up as described in established policies and procedures.Ability to effectively manage multiple priorities in a fast paced environment.Ability to work independently and in a team environment.
Physical Requirements and Working Conditions:Exposed to a normal office environment.Must be able to sit majority of the day, and occasionally stand, walk, bend, stoop and twist torso.Must be able to lift and carry up to 10 lbs frequently and occasionally lift up to 20 lbs.Requires functional vision, speech, and hearing.This position requires travel so may be exposed to severe weather and road conditions.Operates all equipment necessary to perform the job.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.