HRA Call Center Agent

Job Title: HRA Call Center Agent

FLSA Status: Non-Exempt

Division: HRA Operations

Reports To: HRA Call Center Supervisor

Location: Tampa, FL

Episource, with over 3,000 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 is responsible for promoting the benefit of and scheduling of health risk assessments with members of various clients.  The Call Center Agents will contact the member and secure an appointment with a nurse practitioner for an in-home health assessment.

Responsibilities:

The Call Center Agent’s main responsibility is to conduct outbound calls to health plan members and schedule in home visits.  Actively promotes in-home health assessment appointments to members.  The Agent provides support services to other internal team members by working special projects, manual call lists, etc. as needed.  Works closely with Logistical (Scheduling Coordinator) Team to ensure effective and efficient call center & provider utilization rates. Responsible for providing excellent interactions resulting in meeting/exceeding scheduled rates, call quality guidelines and all other key performance metrics. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:

  • Make outbound calls to designated members with the goal of scheduling an in-home health risk assessment
  • Actively participates and contributes to overall team cohesiveness and achievement of team goals
  • Meet monthly key performance goals including, quality, productivity, aht, vph, scheduled rates, decline rates, contact rates, and other key performance indicators
  • Follow and comply with established standard operating process for all activities and procedures including accurately and concisely documenting member details/feedback and special needs indicated during the call
  • Excellent communication and presentation skills to effectively interact with the members resulting in scheduled appointments, addressing member issues, and providing additional information as needed
  • Requires an individual to maintain the ability to work in an environment with PHI / PII data
  • May be assigned other duties
  • Must maintain compliance with all company policies and procedures.

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

  • High member schedule rate (i.e., the percentage of members who accept a visit)
  • Low member decline rate (i.e., the percentage of members who decline a visit)
  • High productivity rates (calls per hour, contacts per hour, scheduled visits per hour, aht, etc.)
  • Schedule adherence
  • Overall Compliance with all Key Performance Metrics, including but not limited to, Quality, Scheduled Visits, Invalids, Declines, and Attendance.

Note: reasonable benchmarks for performance metrics to be determined over time & experience

 Additional Responsibilities

  • Must be able to work under pressure and meet deadlines, while maintain a positive attitude and provide exemplary customer service.
  • Ability to work independently and in teams to carry out assignments to completion within parameters of instructions given, prescribed routines and standard accepted practices.
  • Develops and maintains strong relationships with all internal and external customers/employees

Education / Requirements:

  • High School Diploma or G.E.D. required.
  • Associate degree preferred.
  • Excellent verbal and written communication skills, including ability to effectively communication with internal and external customers.
  • Knowledge of 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.

PHYSICAL REQUIREMENTS:

  • Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting productivity standards.
  • Must be able to lift and carry up to 35 lbs.
  • Must be able to talk, listen, speak and view (close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus) as required to:
  • Read printed material on paper and similar medium, on a PC or similar electronic devices.

EEO POLICY STATEMENT:

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, and transfer, leaves 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.