Overview:
The Customer Service Specialist is responsible for processing and completing internal and external referrals, acts as primary liaison between external agencies and internal agency departments and completes all required administrative paperwork and data entry for customer records. Coordinates all activities related to initial intake, level of care screening, insurance verification and payment coordination. Regularly interfaces face-to-face and by telephone with customers as well as with all agency and County electronic systems connected to client care and billing. Supports requirements related to County and State Access requirements.
Responsibilities:
- Answers phones and obtains all information related to initial request for services, referral source, basic demographics, and insurance/payment responsibility
- Completes comprehensive phone screens and utilizes comprehensive knowledge of the Agency’s continuum of care to make initial referral recommendations
- Answers questions regarding service availability
- Ensures that non-English language needs are met to facilitate effective access
- Creates electronic record and/or documents in other logs or databases as indicated
- Triages services to other community resources if applicable
- Maintains all tracking systems
- For foster youth, obtain qualifying minute order. Also obtains other relevant court documents as needed.
- Verifies/clarifies insurance eligibility, co-pays, deductibles and enters into electronic record
- Coordinates with program manager, family, and billing re: payment issues
- Ensures that all initial and ongoing insurance authorization information is recorded in clinical record
- Liaison between all internal program departments regarding referral coordination
- Routinely maintains, verifies and confirms data entry accuracy and consistency between internal electronic records and all County systems
- Participates as member of team in QA/QI activities
- Prepares variety of reports as requested
- Works closely with Program Manager to continually build, improve, and refine Customer Services infrastructure
- Maintains expertise in agency-wide procedures
- To serve as back-up to any HIM and other Customer Services staff absences.
- Other duties as assigned to support specific agency/business need and/or enhancement of operations
Qualifications:
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions.
- High School Diploma or GED and two (2) years of relevant experience, or equivalent combination of education and experience (two years of relevant experience equals one year of education)