Intake and Customer Service Specialist - ACCESS

Job Title: Intake and Customer Service Specialist

Job Status: Full-time

Job Summary: Under general supervision, the Intake and Customer Service Specialist assures the accessibility of effective community services that empowers individuals and families to achieve an enhanced quality of life. They interact with customers by addressing inquiries and resolving client complaints. They provide a high level of customer service support and handles matters professionally and responsibly and administer medical billing tasks. Quality customized services, client care and satisfaction are the ultimate goal.

Essential Duties and Responsibilities:

• Welcome people to the department and program
• Answer telephone calls, questions and service inquiries about services
• Orient individuals to service benefits and resources available
• Provide a warm transfer with customer-centered service to ensure client makes the initial contact with funders and health plans
• Provide information on how to access services and rights processes
• Assist with resolution of local complaints, grievances, and appeals processes
• Survey, track, trend, and report on member/provider experiences
• Provide behavioral health, customer service, outreach, education, and training support.
• Maintain current listings of all providers, both organizations and practitioners, with whom the DWIHN/MCCMH or programs have contracts, the service they provide, languages they speak including American Sign Language, any specialty for which they are known and accommodations for individuals with a disability
• Follow up with appropriate staff and document results on the internal system and calendars, if applicable
• Schedule intake appointments with relevant program staff
• Record customer information and outcomes and enter services on the appropriate internal system, highlighting all given resources
• Explain program requirements and any fees, if applicable, to clients
• Maintain current knowledge regarding ACCESS programs and field of work
• Refer clients with possible well-being matters to internal resources when necessary
• Track referrals and enrollment status of clients, document outcome of the referral and enrollment, and provide support as appropriate, document barriers to enrollment, if any
• Provide excellent internal/external customer services via telephone, e-mail, or face-to-face to assist customers with their eligibility and enrollment needs and answer questions or concerns regarding program processes and requirements
• Provide an overview of all internal services and help refer and/or enroll the client to obtain the necessary service and encourage participation
• Keep current with trends and developments related to essential job competencies
• Protect confidentiality of customers at all times and abide by HIPPA law and confidentiality policy
• Follow policies and procedures at all times and complete documentation in appropriate systems
• Attend regular team meetings, and share any helpful/challenging/issues
• Attend monthly staff meetings and all mandatory organization activities
• Take fax orders, phone calls, in person new clients’ and schedule new program screenings and evaluations
• Project positive, flexible attitude in attempting to meet Clients’ scheduling needs
• Perform receptionist functions and assure that the telephone is answered, visitors/clients/patients are greeted, in a courteous, professional and timely manner
• Perform registration functions and assure timely, efficient, and customer-friendly registration are met
• Verify and process program eligibility and benefits verification for all clients
• Assist in resolving any client issues generated through contract account denials
• Verify client insurance coverage and prepare EMR case with all demographic and benefits information
• May process insurance pre-authorizations for patients, if applicable, for program
• Work staff to resolve any issue to ensure timely filing and clean-claim requirements
• May enroll and inform patients and clients about insurance affordability through the local health exchanges and public insurance programs to encourage participation
• May issue notices of hot jobs and in-demand trainings to clients
• May issue notices and revised fee agreements while compiling data and entering information for sliding scale fee reductions
• May pre-register clients for all disciplines before first appointment, preparing chart within EMR
• Operate standard office equipment and use required software applications
• Perform other duties and responsibilities as assigned

Knowledge, Skills and Abilities:

Knowledge of:

• Uninsured and underserved populations
• Commercial and worker’s compensation insurance

Skill in:

• Critical thinking with the ability to effectively problem solve (e.g., able to determine if a client issue requires immediate provider attention if there are significant changes to the client history or other clinical issues that are presented)
• Strong customer service skills
• Strong multi-tasking skills
• Organizational and time management skills to effectively juggle multiple priorities, time constraints and large volumes of work
• Operating standard office equipment and using required software applications for program area and other applications, including Microsoft Office

Ability to:

• Operate a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, Microsoft Word, Excel, Outlook, intranet and computer navigation
• Master the rules of a number of complex public benefits programs
• Establish positive relationships with associates, volunteers and third-party intermediaries
• Be highly organized with the ability to multi-task and adapt to changing priorities
• Establish and meet deadlines
• Evaluate each registration/admission and be alerted to potential problems, including pre-certification or financial assistance for the client
• Communicate effectively with both written and verbal forms, including proper phone etiquette
• Work collaboratively in a team-oriented environment; courteous and friendly demeanor
• Work effectively with various levels of organizational members and diverse populations including ACCESS staff, clients, family members, insurance carriers, outside customers, vendors and couriers
• Cross-train in other areas of practice in order to achieve smooth flow of all operations
• Exercise sound judgment and problem-solving skills, specifically as it relates to resolving billing and coding problems
• Handle client and organizational information in a confidential manner
• Work under minimal supervision

Educational/Previous Experience Requirements:

• Minimum Degree Required:
  • High School or GED
  • Associate degree preferred

• Required Disciplines:
  • Health Administration, Business Administration or related field approved by Human Resources

~and~

• For Workforce Development, at least 3-5 years previous workforce development experience in a funded program that includes enrolling into a funded program, intake, referral to services for training, supportive services and knowledge of program policies and system partners, or equivalent combination of education, experience and/or training approved by Human Resources
• For Community Health & Research Center, at least 3-5 years previous experience including experience with medical insurance processing, Medicare, Medicaid, CCI edits, Medicare Functional Therapy Reporting and Therapy Cap requirements, local payer coding and billing guidelines as they pertain to physical, occupational, or speech therapy preferred or equivalent combination of education, experience and/or training approved by Human Resources

Licenses/Certifications:

• Licenses/Certifications Required at Date of Hire: None

Working Conditions:

Hours: Normal business hours, some additional hours may be required

Travel Required: Some local travel may be required

Working Environment: Climate controlled office