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JOB PURPOSE:
The Contact Center Specialist is responsible to receive, triage, process and/or investigate, as necessary, all inbound phone / emails inquiries. The role will ensure that they resolve requests in a timely and efficient way while in compliance with the relevant policies & procedures. The contact center specialist will be expected to develop and maintain in strict confidence its findings from case investigations related to highly sensitive & confidential issues reported by callers.
JOB RESPONSIBILITIES:
- Manage all call requests / issues received via phone calls / Emails from outlook and care compass requests from Interdisciplinary Team (IDT) and/or vendors etc., related to (but not limited to) PACE program general services, transportation, DME orders, home health aide (HHA), personal care aid (PCA), CDPASscheduling / coordination, PERS, claims, grievances, appeals, status of prior requests / issues reported etc.
- Complete assessment and coordination notes for all transactions into EMR database with documentation reflecting context of the call (examples: service plans, authorizations, encounters, coordination notes, grievances, call assessments, demographic updates etc.) in designated systems.
- Outreach to inquiring callers to keep them informed about their issues / requests status or resolution.
- Complete Quality validation calls and Capture and modify any demographic missing by the PACE staff who submitted the original request, and communicate to all parties key updates to ensure that deliverables are achieved for the participant
- Assist the supervisor with a variety of administrative tasks, including but not limited to, providing training to staff, managing, and handling escalated calls as needed.
- Actively track outstanding caseload and prioritize escalated issues, disputes, and replacement requests as assigned on the worklist.
- Adhere to HIPAA policies when working with confidential information, such as patient services and data summaries, quality assurance reports and use any/all sources of information (ie. Staff documentation errors, missing information in Care Compass, validation calls, grievances, etc.).
- Provides general administrative oversight support as needed.
- Maintains departmental quality and productivity goals.
- Adhere to company and department policies and procedures.
- Adheres to all applicable compliance requirements and the Code of Conduct.
QUALIFICATIONS:
EDUCATION: Associates Degree preferred or equivalent relevant customer service, quality, and auditing experience preferred.
Additional Requirements:
- Able to pass a typing test with at least 45 WPM.
- Bilingual Requirement: Spanish, Russian, Chinese, Bengali, Korean
- 1 2 years experience of in customer service, quality, and/or auditing experience.
- Excellent written and verbal communication skills.
- Ability to thrive in a fast-paced environment and meet assigned deadlines.
- Excellent organizational skills, accuracy, and attention to detail.
- Ability to operate both independently and collaboratively as required.
- Proficiency in Microsoft Office Suite, including Word, Excel and Outlook.
Physical Requirements
Individuals must be able to sustain certain physical requirements essential to the job. This includes, but is not limited to:
- Standing Duration of up to 6 hours a day.
- Sitting/Stationary positions Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods.
- Lifting/Push/Pull Up to 50 pounds of equipment, baggage, supplies, and other items used in the scope of the job using OSHA guidelines, etc.
- Bending/Squatting Have to be able to safely bend or squat to perform the essential functions under the scope of the job.
- Stairs/Steps/Walking/Climbing Must be able to safely maneuver stairs, climb up/down and walk to access work areas.
- Agility/Fine Motor Skills- Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools to complete essential job functions (ie. typing, use of supplies, equipment, etc.)
- Sight/Visual Requirements Must be able to visually read documentation, papers, orders, signs, etc., and type/write documentation, etc. with accuracy.
- Audio Hearing and Motor Skills (language) Requirements Must be able to listen attentively and document information from patients, community members, co-workers, clients, providers, etc., and intake information through audio processing with accuracy. In addition, must be able to speak comfortably and clearly with language motor skills for customers to understand the individual.
- Cognitive Ability Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job.
Job Type: Full-time
Pay: $38,000.00 - $48,000.00 per year
Benefits:
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
- Work from home
Schedule:
- 8 hour shift
- Monday to Friday
Ability to commute/relocate:
- Fort Smith, AR: Reliably commute or planning to relocate before starting work (Preferred)
Application Question(s):
- Are you able to type 45 WPM?
- What is your desired salary?
Education:
- High school or equivalent (Preferred)
Experience:
- call center: 1 year (Preferred)
Language:
Work Location: Remote
Kinship Health
