|Date Posted||April 29, 2021|
Call Centre / CustomerService
Positi o n Description
PSR - Patient Services Representative
PSRs are Healthcare Warriors; they are helpers, researchers, collaborators, investigators, problem solvers and subject matter experts in health benefits navigation. They provide guidance and advocacy services for clients, and work as a conduit between members and service providers to assist them through the complicated task of untangling the web that is healthcare. They must possess a unique combination of skills that include critical thinking, tech savviness, agility , empathy , listening, and strong verbal and written communication skills. This includes the ability to breakdown complex situations and communicate them in easily understandable terms. They must be intuitive and enjoy the thrill of solving intricate puzzles , as well as, have a passion for understanding and helping others through their unchosen healthcare journey is essential.
Essential Roles and Responsibilities
% of Time Spent
- Provide exceptional customer service through inbound/outbound calls.
- Offering empathetic and individualized member guidance, work can include verifying benefits; creating authorizations for treatment based on the members' health plan .
- Asking probing questions to recogniz e addition needs , including those beyond their healthcare benefits and providing additional resources/solutions.
- Acting as advocates for our members by c ommunicating with network liaisons , medical and finance staff at hospitals and physicians' offices as an advocate for our members; Investigating billing discrepancies and claim issues.
- Work in close collaboration with Quantum Health nursing/medical staff and identify when member should be connected with a QH nurse.
- PSRs must be highly accountable by following-up and following-through to ensure our members' needs are met. The Quantum term for this is "Stick With Them".
- Participate in Quantum Health's business growth projects as needed.
Skills and Qualifications
- Full-time position requires successful completion of a 6 weeks of training , which includes passing two assessments : Monday - Friday from 9:00 AM - 6:00 PM.
- PSRs participate in a three-week classroom training program , where they have requisite reading and homework. They are then required to pass a comprehensive assessment prior to moving into a three-week cultivation period. During cultivation, PSRs take live member and provider calls and begin solving member issues under very close supervision. At the conclusion of cultivation, PSRs are required to pass a final assessment.
- Upon successful completion, they are assigned to a Pod, and shift is assigned within hours of 10:00 AM - 10:00 PM Monday - Friday as business needs dictate
- High school diploma or equivalent
- Proficient in Microsoft Word and Excel
- Accountable and reliable
- Adaptable with a desire to learn and acquire new skills
- Ability to type and answer emails in a timely manner
- Strong desire to help others and caring attitude
- Attentive and good listener
- Strong customer service skills
- Ability to function as a team member within one's own group
- Ability to work independently without close supervision
- Ability to receive and accept feedback from multiple support sources (Manager, Team Leads, Quality Coaches, Peers, etc.)
- Able to remain in one set location for long periods of time
- All job offers are contingent on successful completion of a background check
- Protect and take care of our company and member's data every day by committing to work within our company ethics and policies