Scheduling Customer Service Representative

Location Address:

Compensation Pay Range:

Summary:

Responsibilities:

• Deliver exceptional customer service by assisting patients with care coordination, including patient triage, appointment scheduling, referrals, patient messaging, and maintenance of accurate demographic information.

• Respond to incoming inquiries through a skill-based call routing system while meeting established quality, productivity, and performance standards. Consistently provide timely, effective resolution during the initial contact whenever possible. Conduct outbound calls as needed to support organizational programs, initiatives, and patient care objectives.

• Build and maintain positive relationships with patients, providers, and business partners. Act as a patient advocate by collaborating with healthcare practitioners and other stakeholders to address concerns, resolve issues, and enhance the overall patient experience. Promote customer loyalty through responsive service, accuracy, and professionalism.

• Contribute to continuous process improvement efforts by assisting in the development and documentation of workflows, procedures, and best practices. Identify trends in patient inquiries and concerns, perform root cause analysis, and provide recommendations to improve service delivery and operational efficiency.

• Research and resolve patient, provider, and organizational inquiries with accuracy and attention to detail. Utilize available resources, including policies, procedures, provider manuals, knowledge databases, and internal systems, to ensure consistent interpretation of benefits, services, and processes. Communicate findings and resolutions within established service-level expectations.

• Prepare and maintain professional correspondence, reports, and documentation using Microsoft Office applications and other applicable systems.

• Serve as an engaged and collaborative team member, participating in department initiatives, quality improvement projects, and cross-functional teams that support organizational goals and enhance the customer experience.

• Accurately document all patient interactions, including phone calls, emails, written correspondence, faxes, chat communications, and walk-in encounters, ensuring complete and reliable data for reporting, analysis, and follow-up activities.

• Coordinate meetings and communications with patients, providers, customers, and business partners for training, education, reporting, and other operational needs as required.

• Manage the patient encounter from start to finish, including scheduling, registration, collection of copayments, financial counseling and arrangements, charge posting, and reconciliation of collected funds to ensure a seamless and positive patient experience.

Ideal Candidate

The successful candidate is a customer-focused professional with strong communication, problem-solving, and organizational skills who thrives in a fast-paced healthcare environment and is passionate about providing an exceptional patient experience.

Qualifications:

Education & Experience

• High school diploma or equivalent required.

• One (1) to three (3) years of office, business, customer service, or healthcare experience required.

• Call center, claims processing, managed care, and/or enrollment experience preferred.

Knowledge, Skills, & Abilities

• Strong verbal and written communication skills with the ability to effectively interact with members, patients, employer groups, brokers, physicians, and physician office staff.

• Proficiency in Microsoft Office applications, including Excel, Access, and other reporting tools, with the ability to create, organize, and analyze data and reports.

• Working knowledge of CRM systems, Epic, and other healthcare databases preferred.

• Understanding of healthcare reimbursement methodologies, including DRG, Relative Value Systems (RVS), Per Diem, Fee Schedules, and Capitation preferred. Knowledge of risk-sharing programs is a plus.

• Knowledge of medical terminology and the ability to learn, retain, and accurately communicate health plan benefits, policies, and procedures.

• Strong organizational, analytical, and problem-solving skills with exceptional attention to detail.

• Ability to manage multiple priorities, meet deadlines, and maintain high-quality standards in a fast-paced environment.

• Demonstrated ability to work independently and collaboratively as a productive team member.

• Ability to remain professional, customer-focused, and effective under pressure.

• Typing proficiency of at least 30 words per minute with 90% accuracy.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.