Intake and Customer Services Specialist Department: Workforce DevelopmentLocation: Detroit, MISTART YOUR APPLICATION (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?reqid=3021094&source=3021094-CJB-0) Job Title: Intake and Customer Service Specialist Job Status: Full-time Job Summary: Under general supervision, the Intake and Customer Service Specialist assures the accessibility of effective community services that empowers individuals and families to achieve an enhanced quality of life. They interact with customers by addressing inquiries and resolving client complaints. They provide a high level of customer service support and handles matters professionally and responsibly and administer medical billing tasks. Quality customized services, client care and satisfaction are the ultimate goal.Essential Duties and Responsibilities:
Welcome people to the department and program
Answer telephone calls, questions and service inquiries about services
Orient individuals to service benefits and resources available
Provide a warm transfer with customer-centered service to ensure client makes the initial contact with funders and health plans
Provide information on how to access services and rights processes
Assist with resolution of local complaints, grievances, and appeals processes
Survey, track, trend, and report on member/provider experiences
Provide behavioral health, customer service, outreach, education, and training support.
Maintain current listings of all providers, both organizations and practitioners, with whom the DWIHN/MCCMH or programs have contracts, the service they provide, languages they speak including American Sign Language, any specialty for which they are known and accommodations for individuals with a disability
Follow up with appropriate staff and document results on the internal system and calendars, if applicable
Schedule intake appointments with relevant program staff
Record customer information and outcomes and enter services on the appropriate internal system, highlighting all given resources
Explain program requirements and any fees, if applicable, to clients
Maintain current knowledge regarding ACCESS programs and field of work
Refer clients with possible well-being matters to internal resources when necessary
Track referrals and enrollment status of clients, document outcome of the referral and enrollment, and provide support as appropriate, document barriers to enrollment, if any
Provide excellent internal/external customer services via telephone, e-mail, or face-to-face to assist customers with their eligibility and enrollment needs and answer questions or concerns regarding program processes and requirements
Provide an overview of all internal services and help refer and/or enroll the client to obtain the necessary service and encourage participation
Keep current with trends and developments related to essential job competencies
Protect confidentiality of customers at all times and abide by HIPPA law and confidentiality policy
Follow policies and procedures at all times and complete documentation in appropriate systems
Attend regular team meetings, and share any helpful/challenging/issues
Attend monthly staff meetings and all mandatory organization activities
Take fax orders, phone calls, in person new clients- and schedule new program screenings and evaluations
Project positive, flexible attitude in attempting to meet Clients- scheduling needs
Perform receptionist functions and assure that the telephone is answered, visitors/clients/patients are greeted, in a courteous, professional and timely manner
Perform registration functions and assure timely, efficient, and customer-friendly registration are met
Verify and process program eligibility and benefits verification for all clients
Assist in resolving any client issues generated through contract account denials
Verify client insurance coverage and prepare EMR case with all demographic and benefits information
May process insurance pre-authorizations for patients, if applicable, for program
Work staff to resolve any issue to ensure timely filing and clean-claim requirements
May enroll and inform patients and clients about insurance affordability through the local health exchanges and public insurance programs to encourage participation
May issue notices of hot jobs and in-demand trainings to clients
May issue notices and revised fee agreements while compiling data and entering information for sliding scale fee reductions
May pre-register clients for all disciplines before first appointment, preparing chart within EMR
Operate standard office equipment and use required software applications
Perform other duties and responsibilities as assigned
Knowledge, Skills and Abilities:
Knowledge of:
Uninsured and underserved populations
Commercial and worker-s compensation insurance
Skill in:
Critical thinking with the ability to effectively problem solve (e.g., able to determine if a client issue requires immediate provider attention if there are significant changes to the client history or other clinical issues that are presented)
Strong customer service skills
Strong multi-tasking skills
Organizational and time management skills to effectively juggle multiple priorities, time constraints and large volumes of work
Operating standard office equipment and using required software applications for program area and other applications, including Microsoft Office
Ability to:
Operate a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, Microsoft Word, Excel, Outlook, intranet and computer navigation
Master the rules of a number of complex public benefits programs
Establish positive relationships with associates, volunteers and third-party intermediaries
Be highly organized with the ability to multi-task and adapt to changing priorities
Establish and meet deadlines
Evaluate each registration/admission and be alerted to potential problems, including pre-certification or financial assistance for the client
Communicate effectively with both written and verbal forms, including proper phone etiquette
Work collaboratively in a team-oriented environment; courteous and friendly demeanor
Work effectively with various levels of organizational members and diverse populations including ACCESS staff, clients, family members, insurance carriers, outside customers, vendors and couriers
Cross-train in other areas of practice in order to achieve smooth flow of all operations
Exercise sound judgment and problem-solving skills, specifically as it relates to resolving billing and coding problems
Handle client and organizational information in a confidential manner
Work under minimal supervision
Educational/Previous Experience Requirements:
Minimum Degree Required:
High School or GED
Associate degree preferred
Required Disciplines:
Health Administration, Business Administration or related field approved by Human Resources
and
For Workforce Development, at least 3-5 years previous workforce development experience in a funded program that includes enrolling into a funded program, intake, referral to services for training, supportive services and knowledge of program policies and system partners, or equivalent combination of education, experience and/or training approved by Human Resources
For Community Health & Research Center, at least 3-5 years previous experience including experience with medical insurance processing, Medicare, Medicaid, CCI edits, Medicare Functional Therapy Reporting and Therapy Cap requirements, local payer coding and billing guidelines as they pertain to physical, occupational, or speech therapy preferred or equivalent combination of education, experience and/or training approved by Human Resources
Licenses/Certifications:
Licenses/Certifications Required at Date of Hire: None
Working Conditions:
Hours: Normal business hours, some additional hours may be requiredTravel Required: Some local travel may be requiredWorking Environment: Climate controlled officeSTART YOUR APPLICATION (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?reqid=3021094&source=3021094-CJB-0)
