Job Description

Episource, with over 3500 employees worldwide, is a leading provider of risk adjustment services and solutions for health plans. Our services help Medicare Advantage, Commercial/Exchange, and Medicaid managed care plans improve and support accurate reimbursement in a post-Affordable Care Act market. Our services include retrospective chart reviews, medical record retrieval, HEDIS/ACO quality reporting, and data analytics, allowing payers and providers to dramatically reduce costs and improve quality of care.

JOB SUMMARY:

The Health Risk Assessment (HRA) Call Center Agent primary responsibility is to conduct telephony outreach to members of identified health plans to promote the benefits of obtaining and scheduling an in-home and/or tele-health visit by a licensed nurse practitioner.

ESSENTIAL DUTIES & RESPONSIBILITIES:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:

• Conduct outbound telephony outreach to health plan members and schedule in-home and/or tele-health visits.
• Actively promotes the benefits of in-home and/or tele-health assessment appointments to members.
• Responsible for meeting or exceeding provided objectives and goals, for quality and performance KPI’s and metrics as required to obtain client/company expectations.
• Actively participates and contributes to overall team cohesiveness and achievement of individual and team goals.
• Accurately and concisely document each call while continuing to interact with the member.
• Excellent communication and presentation skills to effectively interact with the members.
• Ability to work under pressure and meet deadlines, while maintain a positive attitude and provide exemplary customer service.
• Ability to work with minimal supervision.
• Ability to navigate information coming from multiple platforms and prioritize appropriately (Slack, email, Salesforce, telephony, etc….)
• Accurate data entry of information coming from the multiple platforms
• Must maintain compliance with all company policies and procedures.
• May be assigned other duties.

Metrics of success for the HRA Call Center Agent role will include:

• Key Performance Metrics, including but not limited to, Quality, Scheduled Visits, Invalids, Declines, and Attendance.

QUALIFICATIONS / REQUIREMENTS:

• High School Diploma or G.E.D. required.
• Associate degree preferred.
• 2+ years prior contact center inbound/outbound experience; Healthcare industry experience preferred.
• 2+ years of customer service experience preferred.
• Ability to use a computer with good working knowledge of standard operating systems (Windows, MS Word, MS Excel, Internet, and other applicable systems.)
• Ability to operate standard call center telephony tools.
• Excellent verbal and written communication skills, including ability to effectively communication with internal and external customers.
• Sales background with customer preferred.
• Strong listening skills.
• Ability to achieve thoroughness and accuracy when completing a task.
• Ability to seek solutions to aid in member interaction.
• Knowledge of PHI/HIPAA Compliance rules and regulations a plus.
• Professionalism in appearance, communications and demeanor.
• Must be able to work independently with limited supervision.
• Must be organized and detail oriented.

Episource, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Episource, LLC complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.

Episource, LLC expressly prohibits any form of unlawful employee harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Episource, LLC employees to perform their expected job duties is absolutely not tolerated.

Episource, with over 3500 employees worldwide, is a leading provider of risk adjustment services and solutions for health plans. Our services help Medicare Advantage, Commercial/Exchange, and Medicaid managed care plans improve and support accurate reimbursement in a post-Affordable Care Act market. Our services include retrospective chart reviews, medical record retrieval, HEDIS/ACO quality reporting, and data analytics, allowing payers and providers to dramatically reduce costs and improve quality of care.

JOB SUMMARY:

The Health Risk Assessment (HRA) Call Center Agent primary responsibility is to conduct telephony outreach to members of identified health plans to promote the benefits of obtaining and scheduling an in-home and/or tele-health visit by a licensed nurse practitioner.

ESSENTIAL DUTIES & RESPONSIBILITIES:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:

• Conduct outbound telephony outreach to health plan members and schedule in-home and/or tele-health visits.
• Actively promotes the benefits of in-home and/or tele-health assessment appointments to members.
• Responsible for meeting or exceeding provided objectives and goals, for quality and performance KPI’s and metrics as required to obtain client/company expectations.
• Actively participates and contributes to overall team cohesiveness and achievement of individual and team goals.
• Accurately and concisely document each call while continuing to interact with the member.
• Excellent communication and presentation skills to effectively interact with the members.
• Ability to work under pressure and meet deadlines, while maintain a positive attitude and provide exemplary customer service.
• Ability to work with minimal supervision.
• Ability to navigate information coming from multiple platforms and prioritize appropriately (Slack, email, Salesforce, telephony, etc….)
• Accurate data entry of information coming from the multiple platforms
• Must maintain compliance with all company policies and procedures.
• May be assigned other duties.

Metrics of success for the HRA Call Center Agent role will include:

• Key Performance Metrics, including but not limited to, Quality, Scheduled Visits, Invalids, Declines, and Attendance.

QUALIFICATIONS / REQUIREMENTS:

• High School Diploma or G.E.D. required.
• Associate degree preferred.
• 2+ years prior contact center inbound/outbound experience; Healthcare industry experience preferred.
• 2+ years of customer service experience preferred.
• Ability to use a computer with good working knowledge of standard operating systems (Windows, MS Word, MS Excel, Internet, and other applicable systems.)
• Ability to operate standard call center telephony tools.
• Excellent verbal and written communication skills, including ability to effectively communication with internal and external customers.
• Sales background with customer preferred.
• Strong listening skills.
• Ability to achieve thoroughness and accuracy when completing a task.
• Ability to seek solutions to aid in member interaction.
• Knowledge of PHI/HIPAA Compliance rules and regulations a plus.
• Professionalism in appearance, communications and demeanor.
• Must be able to work independently with limited supervision.
• Must be organized and detail oriented.

Episource, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Episource, LLC complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.

Episource, LLC expressly prohibits any form of unlawful employee harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Episource, LLC employees to perform their expected job duties is absolutely not tolerated.

Company Description

ABOUT US: SIMPLE, QUALITY, AND COST-EFFECTIVE SOLUTIONS TAILORED TO THE NEEDS OF OUR CLIENTS. Episource is driven to collect data that's insightful and accurate. With innovative technology and a global services model, we offer intuitive analytics to impact meaningful growth. From robust Risk Adjustment Analytics, Retrospective Chart Reviews, Quality Reporting, Encounter Data Submissions, and Clinical Services, Episource starts with the smallest of details and translates them to create better patient insights around disease profiles and care gaps. We know that behind each chart and every code is a real person. Humanity is our binding element, and we have your members in mind. Our vision is to provide health information exchange solutions that allow healthcare organizations to safely and efficiently manage member-centric data, quality of care initiatives, member intervention and management programs, risk adjustment programs in Medicare, Medicaid, Commercial, and Exchanges. Episource emphasizes driving value, operational excellence, respect, and integrity in all aspects of our operational and professional conduct, while striving to reflect the highest ethical standards in our relationships with members, providers, and our clients. Embracing a hybrid model that caters to the requirements of the global market, Episource concentrates application and functional expertise located both onshore and offshore, where we leverage best practices and economies of scale. Our highly-skilled workforce is trained in a consistent client delivery approach that emphasizes value, and enables clients to focus more on their core competencies.