Patient Communication Specialist II

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The Patient Communication Specialist II (PCS II) will serve as one of the primary points of contact for patients and clinician customers at CND Life Sciences. The primary responsibilities of the PCS will be to manage outbound communication with patients and clinician customers regarding benefit verifications, prior authorizations and other pre-authorizations for CND's diagnostic tests; communicate benefits verification and benefits verification to prior authorization conversion; communicate any results to patients and/or clinicians; coordinate care by facilitating the scheduling process between patients and clinician customers in a compliant manner; answer level I RCM and science questions.

The PCSII will work closely with the Clinical Account Manager in their territory and regularly collaborate with the broader Revenue Cycle Management and Clinical Services departments. The PCSII will have excellent written and verbal communication skills, high attention to detail and be able to document all information in CND's customer relationship management system (Salesforce) in a timely and accurate manner.

Job Responsibilities:

• Make, receive, and process multiple incoming calls in a prompt, efficient and courteous manner and provide personalized patient and clinician customer experience.
• Call and receive calls from patients and clinician customers to discuss benefit verifications, prior authorizations, and other pre-authorizations (including, but not limited to insurance status, in-network and out-of-network benefits, and patient responsibility estimates) and coordinate care in a compliant manner.
• Help to connect patients to care by coordinating patient office visits, as requested by the patient, following protocol and guidelines.
• Collaborate with patients and clinician customers to assist in updating, rescheduling, or cancelling appointments as requested.
• Help Patient Access complete and re-process benefit verifications, prior authorizations, or other pre-authorizations by verifying or collecting patient demographic, contact, and insurance information.
• Outbound follow up calls to patients to communicate their benefits.
• Document all communication with patients, clinician customers, internal personnel in Salesforce.
• Ensures calls from clinician offices reach the correct department for call resolution if unable to assist (i.e., payors, providers, patients, and other stakeholders)
• Send clinics updates when benefits are being converted.
• Respond to broad questions and inquiries from patients and clinician customers.
• Use and disclose CND patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards and at all times observes, respects, and protects PHI.
• Promote positive relationships with patients, clinician customers, co-workers, and the public through a high level of personal attention and service as well as in accordance with CND policies.
• Consistently exhibit behavior and communication skills that demonstrate CND's commitment to superior customer service, including quality, care, and concern with each internal and external customer
• Adhere to all department and organization policies and procedures.
• Support the rest of Patient Access with other tasks as requested.
• Other duties as assigned

Knowledge, Skills & Experience:

• 3 years of patient communication experience in a medical front office or a medical call center required; experience communicating with an older patient demographic preferred.
• Experience in a call center environment highly desired.
• Strong knowledge of healthcare insurance and benefits
• Strong ability to explain the nuances of health insurance, benefits and patient cost sharing to patients and clinician customers.
• High familiarity with health insurance benefit verifications, prior authorizations and other pre-authorizations and high comfort discussing these matters with patients and clinician customers.
• Strong knowledge and compliance with HIPAA and other healthcare regulations
• Ability to collaborate with patients and clinician customers, as well as internal clinical and non-clinical staff, in potentially stressful situations.
• Mindfulness to detail and documentation in Salesforce of all pertinent information in an accurate and timely manner
• Excellent verbal and written communication skills
• High fluency in Microsoft Office (including, but not limited to Outlook, Excel, Word, PowerPoint, SharePoint, and Teams), Google Docs, Salesforce and other software and IT platforms.
• Strong critical thinking skills.
• Strong ability to think on the fly and maintain a conversation while doing so.
• Strong ability to organize and interpret data.
• Strong judgment, tact, and diplomacy
• Ability to work effectively in a team environment

Education, Certifications & Licensures:

• High school diploma or GED certificate required.
• Associates degree preferred.
• Completion of a relevant medical program or licensing highly preferred

Other:

• Contact may involve dealing with people who are angry or upset.
• Must possess the ability to sit or stand for extended periods.
• Ability to use computers, copiers, fax machines and PDF scanners to create and maintain records.
• Position located in CND's Scottsdale, AZ or Atlanta, GA offices; with discretional flexibility to work remotely; Other locations considered on a case-by-case basis.