Who is Quantum Health? A fast growing company that has a blast delivering better healthcare'while lowering healthcare costs. If you're passionate about helpi|
ng people and want to launch a career at one of the Best Places to Work in Columbus and the US, here's your chance to bring it! We are looking for Spanish Speaking Patient Service Representatives
. 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 approximately 45 to 70 phone calls per 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.
Skills: This position requires the following skills/education:
- Taking phone calls and/or internet inquires 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.
And if you join us, we hope that you'll work hard. Have fun. Reap the benefits.
- 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
- Conversational Spanish and English along with strong written and verbal communication skills.
- Empathetic attitude for patient and providers when addressing issues or concerns;
- Ability to take 45-70 incoming calls per day and deal with high-pressure, often highly emotional situations while maintaining a positive attitude;
- Ability to probe to determine root cause of problems to facilitate resolution of issue;
- Strong customer service skills and/or 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.
- High School diploma or equivalent
On-site fitness facility
Paid maternity and paternity leave for births and adoptions
Domestic partner benefits
Fun Room with a pool table, ping pong table and air hockey
Serenity Room for relaxation and meditation
Frequently catered lunches
Free beverages, snacks and fresh-popped popcorn ALWAYS
Yes, there's also the "normal" medical/dental/vision insurance, flexible spending accounts, life insurance, 401(k), paid time off and more
Think you've got the right stuff? Then apply today!
Founded in Columbus in 1999, Quantum Health is an award-winning care management and health improvement company serving the healthcare needs...