Clinical Call Center Representative TCM/CCM - Bilingual (English/ Spanish)

Key Responsibilities: Conduct inbound and outbound patient calls related to TCM and CCM services. Contact patients following hospital discharge to assist with transitional care coordination and scheduling follow-up appointments. Perform routine outreach to patients enrolled in Chronic Care Management programs. Review patient-reported symptoms, medical concerns, and healthcare needs, escalating clinical issues to the appropriate licensed medical professional. Assist patients with medication-related questions by documenting concerns and referring them to the clinical team when necessary. Identify barriers to care, including transportation, appointment availability, and medication access, and assist with appropriate coordination. Document all patient interactions accurately and promptly in the Electronic Medical Record (EMR) system. Communicate with physicians, nurses, care coordinators, and other healthcare professionals to ensure continuity of care. Provide patient education and reinforce established care plans under the direction of the clinical team. Maintain patient confidentiality and comply with HIPAA regulations and company policies. Meet departmental expectations for call volume, documentation accuracy, and patient follow-up.

Qualifications and Requirements: Bilingual in English and Spanish (required).Previous clinical or hands-on medical experience (required).Background as a Medical Assistant (MA), Licensed Practical Nurse (LPN), Foreign Medical Graduate (FMG), or similar medically trained professional preferred. Experience working in a medical practice, outpatient clinic, hospital, or healthcare call center. Knowledge of medical terminology, common chronic conditions, medications, and basic clinical procedures. Familiarity with Transitional Care Management (TCM) and Chronic Care Management (CCM) programs preferred. Experience using Electronic Medical Records (EMR/EHR) systems. Strong communication, organizational, and multitasking skills. Ability to recognize patient concerns that require clinical escalation. Strong attention to detail and ability to document patient interactions accurately. Ability to work independently and collaboratively in a fast-paced healthcare environment.

Position Expectations: The Bilingual Clinical Call Center Representative is expected to maintain consistent communication with patients, support timely TCM and CCM outreach, ensure accurate documentation, and assist the clinical team in promoting continuity of care and positive patient outcomes. All clinical activities must remain within the employee's training, credentials, authorized responsibilities, and established clinical protocols.