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Mindlance

Appeals Coordinator

united states / Posted
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Title: Care Experience Specialist-Remote

Unit: Care Experience

Duration: 13-week contract with possibilities of extension

Location: Detroit 48202 MI

Shift: M-F 0800-1630; No weekends, no holidays.


Note:

Candidates will be assisting the team that handles patient grievances and complaints.

Workers will be responsible for taking incoming phone calls, gathering all required information, and entering the case into the Genesys Cloud system prior to passing the case off to the permanent team for resolution.

The employees who recieve an average of 100 calls per day with a 20-25 minute average call time.

Attention to detail and communication skills will be crucial for this placement.

Position is fully remote but candidates will be required to be local to pick up equipment.

Company will provide a laptop, Meraki box, and headset.

Minimum internet network requirement is 20MBS upload and download to support base program requirements.

Please take into account if others will be using the same network as this will slow down speeds and require a faster base speed to be able to run the required programs.

Required: High School Diploma or GED (Bachelors preferred), Minimum 3 years experience in a similar role with high call volume and customer service skill, Attention to detail.

Candidates that are highly outgoing will be a good fit for this position.

Manager will likely be reaching out to candidates directly to interview.


Position Summary

Through effective interventions, the Care Experience Specialist (CXS) serves as the first resource for a patient, family, or consumer, concern or inquiry. They identify, investigate, and mitigate point-of-care concerns from escalating to grievances which may result in review by regulatory agencies. The CXS collaborates with multidisciplinary teams to reduce and prevent adverse experience outcomes, thereby minimizing the risk of increased suffering to patients and families.


Principle Duties And Responsibilities:

Leads an investigation of concerns or perceived service failures brought forth by patients and families which are received by phone, email, public submission, contact us forms, My Chart, etc.

Communicates and collaborates with Care Experience Consultant, local teams and/or leadership to resolve service concerns. Ensures all aspects of regulatory compliance are met and closes cases, once complete. For service lines, clinics, and business units, independently assists and mentors managers with complaint event investigations.

Apprises leadership of any compromising events with the potential for regulatory review, legal or patient safety implications, and/or negative publicity.

Participates in self-education related to Exceptional Patient Experience, Patient-Centered Care, and Patient Rights and Responsibilities with Pres

Ganey, The Joint Commission, CMS, and other regulatory agencies. Keeps abreast of trends and best practices in health care experience, quality, patient safety, and reputation management.


Respond, investigate, and triage all calls, public submissions, contact us forms, emails, etc. related to compliments, comments/suggestions, complaints, and grievances.

Use RL to accurately document all comment/suggestions, compliments, complaints, and grievances.

Utilize feedback management system (RL6) for case documentation and triaging grievances to Care Experience Consultants.

Provide service recovery at the point of care.

Work collaboratively with clinical and nonclinical leaders to resolve complaints and grievances according to organizational policy and within regulatory guidelines.

Triage service concerns according to highest priority.

Escalate, as appropriate, risk issues to Care Experience Consultant and Quality/Risk teams.

Track and trend service concerns to identify opportunities for improvement resulting in recommendations to management/leadership.

Utilize electronic medical record (EPIC) to access patient records with the highest expectation of privacy and confidentiality.

Supports and trains other staff members to ensure that the work product supports the organization’s strategies.

Identify creative solutions to exceed customer expectations creating loyal customers and positive endorsements.

Engages in continuous learning of best practices and completes required annual education, including department specific requirements.

Make appropriate recommendations for process improvements that reduce waste and or improve efficiencies on behalf of consumer satisfaction.


EEO: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”