Job Description

Patient Access Navigator, Call Center

Full Time, 80 Hours Per Pay Period, Day shift

Covenant Health Overview:

Covenant Health is the region’s top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times.

Patient Access Navigators have a range of tasks but, their role is to be the main point of contact for customers and patients. This includes removing barriers to care, helping to navigate through healthcare services, offering resources, and helping patients play an active role in their health. Primary responsibilities include: answering incoming calls, live on-line chats and emails; responding to customer needs and inquiries in a professional manner and exhibiting excellent customer service; data entry; verifying insurance benefits with accuracy; resolving customer needs efficiently; scheduling patient appointments; adhering to departmental policies and procedures; projecting a positive image of Covenant Health and its affiliates. This position reports to the Call Center Team Lead and the Call Center Manager.

Responsibilities

• Promotes a positive first image of Covenant Health and its affiliates by communicating clearly with: customers, patients, fellow employees, care team members, and community agencies to facilitate customer care. Handles all inquiries through inbound/outbound calls, online chats and emails professionally, accurately, and efficiently.
• Serves as a primary point of contact for customers and provides navigation through the Covenant Health System by ensuring patients do not encounter any barriers when accessing our services.
• Remains aware of current services offered throughout the health system. Provides advocacy, patient education, and support in accessing community and health system programs and services.
• Responds to customers contacting Covenant Health via MedChat (Helen) in a timely and professional manner. Follows up on MedChat inbox messages using the secure link to answer patient inquiries in a timely manner.
• Responds to emails and online forms submitted in a timely and courteous manner.
• Develops and maintains a strong relationship with internal and external staff responsible for connecting patients with services and appointments.
• Schedules all appointments for new and established patients for Peninsula Outpatient Clinics. Ensures the scheduling process is handled in a professional and courteous manner, fully explaining to the patient the process and what they can expect at their appointment.
• Facilitates and accurately enters patient messages to providers at Peninsula Outpatient Clinics.
• Monitors the Patient Portal to ensure accurate and timely responses are provided to patients established with Peninsula Outpatient.
• Provides switchboard services for Peninsula Hospital and the Covenant Health corporate office during business hours by directing calls to appropriate departments.
• Maintains the Covenant Health physician referral directory database and provides physician referrals to patients looking for a doctor to manage their healthcare needs.
• Processes Physician Information Forms (PIF) for the health system in a timely manner, ensuring all physician information is accurate and updated in all the Covenant applications which allows for accurate and timely billing and adherence to HIPAA and PHI policies.
• Gathers accurate caller/patient demographics and financial/insurance information to process payments or verify insurance benefits. Searches proper identifiers to prevent duplicates.
• Works closely with the business office to ensure notes on Peninsula accounts are updated and entered into the proper computer systems for accurate billing and reimbursement.
• Recognizes, documents, and alerts Call Center Team Lead and Call Center Manager on pertinent procedural changes or trends in customer calls.
• Effectively maintains well-organized documentation pertaining but not limited to class registrations and Covenant Health marketing campaigns.
• Warmly transfer calls to appropriate staff based on customer needs and works to offer information to respond to the needs of the customer.
• Follow up on customer inquiries not immediately resolved. Elevates patient complaints in a timely manner to the appropriate leadership team.
• Follow established departmental guidelines and procedures.
• Attends staff meetings and participates in discussions regarding departmental or hospital updates. Recommends process improvements and makes suggestions on how to efficiently improve work flow.
• Maintains strict confidentiality in accordance with HIPAA and PHI policies. Shreds personal identifiable health information or stores information in a locked cabinet.
• Performs other duties of office personnel on a relief basis or other cross training duties.
• Demonstrates ability to keep up with regulatory and insurance requirements, ensuring that changes are incorporated into daily job functions.
• Displays competence in the use of all IT systems related to insurance verification, patient registration, and scheduling.
• Completes mandatory education requirements annually, works towards achieving goals, objectives, and participates in quality improvement initiatives as requested.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Qualifications

Minimum Education:

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED.

Minimum Experience:

Must be proficient in relevant computer applications. Must demonstrate excellent customer service skills, verbal communication and listening skills. Previous call center or customer service experience is preferred.

Licensure Requirements:

None.