Ivyhill is a seeking Customer Service Representatives for a location in Bethesda,MD. The qualified Customer Service Representatives (CSRs) will provide medical appointment activities for Call Center in government environment .

Duties and Responsibilities:

• Will schedule medical appointments, validating and documenting patient eligibility for services from phone calls, or other methods used for appointment request. Support the Primary Care Manager (PCM) by name processing for appointment and appropriate access to care timeframes allocation of standard appointment types.

• Receive phone calls for appointment related request for the National Capital Region and the Proactive line/POM.

• Must be able to answer 80,000-100,000 incoming calls per month.

• Must be able to handle inbound calls with each agent’s average handle/transaction time per month of less than or equal to 5 mins per call.

• Must be able to proactively schedule an aggregate of 60,000-100,000 appointments per month.

• Must be able to make an aggregate 45,000-60,000 outbound calls per month.

• Will answer ninety percent (90%) of inbound rounded calls with an aggregate of all clerk’s average answer time per month at ninety (90) seconds/1.5 minutes.

• Call abandonment is should for all inbound calls shall be less than or equal to 8% of total inbound calls per month.

• Caller wait in queue for the live appointment clerk/scheduler to schedule/cancel/reschedule should be <45 seconds on a monthly average.

• Agents shall make outbound calls with an aggregate of all clerk’s average handling/transaction time per month of less than or equal to 5 minutes per call.

• Agents will manage the total appointments booked to prevent process and booking errors based on booking protocols from being, committed (does not include patient safety errors).

• Errors are collected from numerous sources including but not limited to Interactive Customer Evaluations (ICE), clinic complaints and customer oversight. Errors shall not exceed in total 0.5% of all appointments booked per month.

• Total number of “failed’ calls for all inbound calls shall not exceed three (3) per month.

• Accurately and courteously schedule appointments in accordance with NCR established standards, policies, and business rules, and the customer's Protocol Website for (600) plus clinic SOPs.

• Proactively call the patient to schedule appointments with PCM or Specialty clinic. Must document each attempt to contact the patient in MHS GENESIS. Provide patient with specific visit instructions based on the booking protocols and /Referral notes.

• Call center Agents shall utilize AVAYA automated Call Distribution (ACD) system/or its successor in accordance with established protocols.

• Document patients who decline offered appointments to update referral record.

• Coordinate healthcare appointments for primary care and specialty care medical services via incoming and outgoing phone calls for (13) Military Treatment Facilities within the National Capital Region.

• Provide appointment documentation to include clinical symptoms, demographic information, and contact outcomes into patient electronic health record (EHR).

• Conduct appointment capacity assessment to offer first available appointments across multiple facilities; document declined appointments into referral and coordinate care with Referral Management Coordinator.

• Collaborate with Referral Management Reviewers to ensure proper scheduling of referrals.

• Verify patient registration information via MHS Genesis Revenue Cycle appointment software prior to scheduling appointments. Correct demographic data as needed.

• Provides feedback to PM regarding patient appointment access and issues encountered during phone call interactions.

• Review health care delivery plans and military status related to patient eligibility in MHS Genesis Revenue Cycle and DEERS. Identifies market forces, patient and beneficiary demand and other issues impacting MTF capabilities.

• Provide clinic appointment access, send electronic messages to doctors, nurse practitioners physician assistants, and nursing staff administrators.

• Search all MTFs for possible capability, based on clinic guidance and available appointments within the MHS Genesis Revenue Cycle.

• Determine appointment needs according to local and regional managed care rules.

• Review health care delivery plans related to patient eligibility status in MHS GENESIS. Correct demographic data, by performing a mini registration update in DEERS (as necessary).

• Validate patient demographics prior to booking appointments.

• Cancels and reschedules appointments adhering to protocols.

• Complete 60-80 calls per day.

• Prioritize beneficiary appointments to be scheduled in accordance with Tricare Access to Care Standards and written guidelines.

• Verify and document eligibility of each patient to whom services are scheduled.

• Direct all questions regarding beneficiary eligibility to the Chief, PAD at the MTF.

• Ensure demographic data information matches MHS GENESIS’ information.

• Send telephone consults to designated triage nurse for PCM immediately following the completion of a Telephone consult.

• Spot check scheduled appointments when required. Refer patients to appropriate MTF and provide advice on location of clinics.

• Notify and direct professional staff and other medical administrative personnel regarding process, policy, and requirements.

Unique Military Healthcare Systems/Procedures:

Specific military systems include, but are not limited to: MHS GENESIS, Revenue Cycle, Power Chart, Microsoft Office Applications to include Microsoft Word, Microsoft PowerPoint, Microsoft Excel, and Microsoft Office TEAMS, Government data repositories such as CAC Enabled Protocol Website, Medical Readiness Portal.

Requirements

The qualified candidate:

• Must be a U.S. Citizen.

• A High School Diploma and/or equivalent.

• Must have t least six (6) months experience in health care administration, business, medical treatment facility, medical environment, or a related discipline. Must have a basic knowledge of clinic standard operating procedures, and various appointment types to analyze and appoint medical referrals. Knowledge of medical terminology information management, or a related discipline is required or any combination of, professional training or work experience, which demonstrates the ability to perform the duties of the position working in a Call Center.

• Basic knowledge of human anatomy and physiology and familiarity with medical terms used to describe the human system.

• Possess knowledge of releasing medical information and legal ethics.

• Ability to perform accurate data entry ensuring that information entered and provided to the patient is correct.

• Superior customer service and organizational skills.

• Effective communication skills both orally and in writing. Operational activities may require coordination with high level officials in civilian and federal agencies.

• Be highly organized, detail-oriented with strong organizational skills and can work effectively and independently at home.

• Working knowledge of DOD, Federal, State, non-profit healthcare systems and organizations, to include DoD Tri-Service Military Healthcare Systems, TRICARE purchased care system, Medicare, Medicaid, VA, Public Health Department, and Regional and local support services.

• Knowledge of Microsoft Office programs, Outlook (email), and Internet familiarity is required. This includes various microcomputer equipment for appointment scheduling, and provider must be able to input, retrieve and format documentation.

Benefits

Ivyhill has a competitive benefits program which includes medical, dental and vision; Life and AD&D insurance; Short- and Long-Term Disability; supplemental Life insurance and a 401(k) Plan.

Ivyhill is an equal opportunity employer. In compliance with Federal and State Equal Opportunity Laws, qualified applicants are considered for all positions applied for without regard to race, color, religion, sex (including pregnancy and gender identity) , national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, veteran status or any other legally protected status.