Patient Services Representative
Quantum Health is a fast growing company delivering better healthcare while lowering healthcare costs. If you are passionate about helping people and want to launch a career at one of the Best Places to Work in Columbus and the USA, now is your time to join our winning culture! We are looking for Patient Services Representative.
Patients Services Representatives (PSRs) are the first and most frequent contact with patients, families, providers, and office staff who utilize Quantum Health's coordinated healthcare program. PSRs take several phone calls each day. Their role is to serve as patient and provider advocate by answering all specific questions, while educating and guiding patients through the complicated process of healthcare. PSRs also follow-up on calls by completing research, solving problems, and contacting various parties to implement solutions. Compared to a typical health plan call center, this position is more intensely focused on problem solving, patient advocacy, education and guidance.
Roles & Tasks: The POD Manager is responsible for determining the specific tasks to be performed by this position. These tasks include but are not limited to:
- Taking phone calls and/or internet inquiries from patients, families, providers, and employer/client representatives and responding to inquiries regarding benefits, eligibility, claims, provider look ups and care coordination processes.
- Completely documenting all contacts with any of these parties.
- Coordinating activities between patients, providers, TPAs, PBMS, and any party impacting the healthcare of a patient, by acting as an advocate for the patient and assisting them to understand their healthcare processes and applicable benefits.
- Assist providers and members with the referral and pre-certification process through coordination of care. The PSR will not be responsible for conducting any utilization or pre-certification activities which require interpretation of clinical information.
- Identify and escalate issues as appropriate.
- Assist with any Quantum Health or Pod related projects as needed.
Skills and Qualifications: This position requires the following skills:
- High School diploma or equivalent
- Minimum 2-3 years experience as a social worker in a healthcare setting familiar with self-insured benefit plans, or 2-3 years experience as a customer service representative or claims adjudicator; or 2-3 years experience working in a healthcare setting familiar with self or fully funded benefit plans
- Empathetic attitude for patient and providers when addressing issues or concerns;
- Ability to probe to determine root cause of problems to facilitate resolution of issue;
- Strong customer service skills and superior phone skills;
- Ability to make decisions that are timely and well thought out that achieve results consistent with business goals and organizational culture;
- Ability to function as a team member with the working group and to interact professionally with other entities both internally and externally;
- Ability to work independently and self-directed with limited need for day to day supervision.
- Ability to manage multiple calls per day and deal with high-pressure, often highly emotional situations while maintaining a positive and professional attitude;
- Ability to use a headset and sit or stand in assigned workspace in front of multiple PC screens for long periods of time;
- All job offers are contingent on successful completion of a background check.
- This is a full-time, non-exempt position that requires successful completion of both our 7 week training program running M-F 9am-6pm, and a HIPAA compliance test. Once completed shifts begin any time within the hours of 10am and 1pm.
Join our Quantum culture which rewards hard work while having fun! Benefits include:
- 120 Hours (3 weeks) Paid Time Off annually
- Medical/dental/vision insurance including domestic partner benefits
- On-site amenities include fitness facility, pool table, serenity room
- We offer a casual dress environment
- Free beverages, snacks and ALWAYS fresh-popped popcorn
Want to join our winning culture? Then apply today