This position provides high level member assistance by scheduling various appointments requested, transferring calls appropriately, composing messages, and providing general information.

• Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.
• Operates in a high volume, highly structured call center environment by responding to incoming calls.
• Determines the type of appointment requested or needed, reviews scheduling mix of various physicians/providers, and them makes appointment utilizing appropriate guidelines.
• Prioritizes member needs and offers alternatives to members when appropriate.
• Utilizes superior customer service skills to provide service to members when diffusing difficult member encounters.
• Uses tact and diplomacy in handling difficult interactions with members.
• Determine if calls are urgent or emergent by listening to the member, following established guidelines, and then transferring the call to a Registered Nurse when appropriate.
• Composes messages for physician/providers, Registered Nurses or other medical staff based on member requests.
• Responds in a courteous and professional manner to general questions, using on-line databases to provide information to any member or other personnel calling the center.
• Identifies ways to improve quality of service to members and recommends steps used to accomplish these changes.
• Must perform all of the above duties while meeting established standard of performance for quality and productivity.
• Performs clerical duties which may include assigning new members a primary care physician, processing self-referral requests, calling patients and booking appointment for specialty appointments, calling members to cancel and reschedule appointments.
• Answer incoming calls.
• Determine type of appointment needed, determine appointment availability and schedule appointments.
• Prioritize members need and offer alternatives to member when appropriate.
• Determine if calls are urgent or emergent and refer to RNs as appropriate following established guidelines.
• Compose messages to providers or other medical staff based on member requests.
• Utilize databases to give information to members and other callers as requested.
• Refer members to eligibility department as appropriate.
• Notify members of appointment/scheduling changes by telephone as directed.
• Schedule, reschedule and/or verify appointments.
• Answer member inquiries.
• Contact appropriate department to obtain medical record numbers of new enrollees.
• Assist in resolving problems related to duplicate medical record numbers.
• Initiate change of physician requests.
• Initiate change forms for corrected medical record numbers.
• Verify and update member demographics.
• Perform on-line inquiry functions.
• Perform data retrieval of computerized data.
• Record and maintain activity logs.
• Clear paper jams and other routine maintenance of printers/copiers.
• Recommend procedure changes.
• Train and orient new or less experienced personnel.
• Serve as resource persons to co-workers and assist in problem solving.
• Perform other activities and duties as directed.
• Initiate telephone calls to physicians or other medical office staff when indicated to assist members.
• Assume other activities and responsibilities from time to time as directed.

Pay Grade: 13

• One (1) year of customer service experience in a service-related industry, preferably healthcare.
• Per the National Agreement, current KP Coalition employees have this experience requirement waived.

• High school diploma or equivalent.

• N/A

• Effective telephone communication skills and excellent interpersonal skills.
• Must obtain passing score on Customer Care Simulation assessment.
• The Customer Care Simulation assessment score must be current within one (1) year (contact Local HR Office for testing).
• Must be able to effectively communicate, verbally and in writing, in English.
• Must complete Service Orientation Assessment.
• As part of applicant process, must take Proofreading Assessment for non KP employees only.

• This is an on-call position; days and hours may vary.
• Working hours may vary.
Will be trained across multiple areas.
• Backfill coverage for MLOA, call outs, etc.

• Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.

• Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty, shows consistency in words and actions; follows through on commitments.

• Job duties with at least occasional or possible access to: (1) patients, the general public, or other employees; (2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (4) controlled substances regulated by federal law or potentially subject to diversion.