Customer Service Representative

Customer Service Representative

Functional Title: Customer Service Representative

Department: Behavioral Health

Position Status: Non-Exempt

Reporting to: Operations Manager

Last revision date: February 2025

Direct Reports: None

Job Purpose/Function

The Customer Service Representative (CSR) is often the first interaction that a client has with the agency. As such, this role is key to ensuring that the programs have a steady, engaged stream of clients, able to take advantage of the available behavioral health programming. Towards that end, the CSR is responsible for ensuring that individuals in need of behavioral health services are greeted appropriately, connected to an admission clinician in a timely manner, that the client's experience is positive, meets their needs and that all back-end paperwork required is complete, accurate and entered into the electronic medical record (EMR).

In addition, the CSR is responsible for ensuring that clients have adequate access to their medical treatment. Specifically, the CSR will ensure that, in coordination with the medical staff, all medical appointments are updated in the electronic medical record, the medication telephone voicemail (Medline) is responded to daily and that the medical staff have the administrative resources necessary to complete their mission.

CSRs will be crossed trained in all aspects of the front and back end office duties so that each can complete every duty, even though they may be assigned a specific subsection of the entire process.

The CSR plays a major role in building resiliency for clients and the community at large. By providing a welcoming environment for clients and program guests, each individual will help foster a sense of commitment to client care to help improve client engagement and ultimately improve outcomes.

Major Responsibilities

The CSR has 5 major responsibilities in accordance with a) agency policies and contractual obligations and b) state/federal regulations/laws and c) accreditation standards:

• Manages agency main phone numbers
  • Ensures main phone line is answered and directs all calls as needed
  • Follows agency script for identified topics, when appropriate
  • Maintains a professional demeanor at all times, regardless of caller reaction(s)
  • Ensures that agency voicemail is empty at the end of each day and all calls directed as needed
• Coordinate and manage back-end agency admission & financial process
  • Ensure every client is registered in the EMR as wanting an assessment in the "Referral Section" of the EMR (a virtual waiting room for potential pre-enrolled clients)
  • Enter client information into the electronic medical record so that the admission clinician can complete an assessment
  • Schedules assessment with appropriate clinical team member following agency protocols
  • Gather and verify insurance information
  • Review payment information with client and have client sign promissory note if co-pay, spend-down or sliding scale is required.
  • Pre-prepare paper admission packets for clients to review and sign. Ensure clients read and complete the forms prior to the assessment, including helping with the completion if needed
  • Schedule appointments for clients who call ahead, with the understanding on the part of the client that walk-ins get priority when the department is overbooked
  • Transfer clients to appropriate clinicians in EMR, when admission counselors are not able to at time of assessment
• Manage the waiting area
  • Ensure all clients are taken care of and connected to their service provider
  • Keep agency-approved food available for all clients
  • Maintain the waiting room area, notifying the supervisor should repairs or improvements be needed, or other issues arise
• Manages the scheduling of medical appointments, when needed
  • Ensures the agency voicemail (Medline) is listened to daily and responded to as needed
  • Re-schedules appointments when nurses are occupied
  • Contacts pharmacies when directed by the medical staff for non-prescriber related items
  • Scans medical forms into the EMR when required by medical personnel (ex: bloodwork results, hospital discharge paperwork, etc)
• Exchanges clinical record information when appropriate and as approved by the Chief Behavioral Health Officer
  • Reviews legal paperwork that asks for clinical record, either from legal system or client request. Ensures they have authority to release protected health information
  • Prints and distributes as outlined in the legal process
  • Maintains a log in the EMR of all instances of clinical record distribution
• All other duties as directed by the Practice Manager

Authorities

1. Schedules intake appointments

2. Makes recommendations to the admission clinicians about potential issues with upcoming assessment, based on their past or present understanding of the client's state of mind.

3. Determines and implements client engagement strategies to motivate the client to complete an assessment, when clients are unsure about the process.

4. Exchanges client protected health information, in writing or electronically, when directed by the Chief Behavioral Health Officer, following all HIPAA and CFR 42 regulations

5. Contacts callers from the agency Medline and answers non-medical questions, when needed

6. Updates medical schedule when directed by the agency medical staff

Performance Indicators

• Clients that report satisfaction with admission process

• EMR accuracy audits

• Insurance verification accuracy (# of rejected claims)

• Medical schedule accuracy

Education and Experience Required

• High school diploma or higher

• Experience working in healthcare, preferably in front desk or financial departments.

• Must have a work history that demonstrates the understanding of a consumer-driven delivery system, accomplishment, punctuality and the ability to work well with colleagues.

• Must have strong communications skills along with the interpersonal skills to work effectively at all levels of the organization and its stakeholders

• Must be computer literate

• Ability to speak Spanish preferred

Confidentiality

The employee will be required to sign a confidentiality agreement. Violation of this agreement may result in disciplinary action up to an including immediate dismissal.

Physical Requirements

Frequent sitting and ability to talk and hear. Frequently required to walk; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; stoop, crouch and kneel. The member must occasionally lift and/or move up to 25 + pounds. The member will be required to travel locally by vehicle, work in an office setting sitting behind a computer, as well as interact with clients. Required to be free from communicable diseases and work closely with clients.

Work Environment

The noise level in the work environment is typical of any residential setting/outpatient treatment facility and ranges from low to high. Frequent interaction with individuals in the program and community.

Agency Disclaimer

The President & CEO may modify this job description based upon agency needs; may require the employee to perform functions beyond those mentioned.