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

Position Summary
Nirvana Healthcare is seeking a bilingual, medically trained Call Center Representative to assist with patient outreach and coordination for our Transitional Care Management (TCM) and Chronic Care Management (CCM) programs.
The ideal candidate will have prior clinical experience, a strong understanding of medical terminology, and the ability to communicate effectively with patients regarding their healthcare needs. This position requires fluency in both English and Spanish and the ability to provide compassionate, professional patient support while working closely with our clinical team.
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.
Preferred Experience
Previous experience conducting patient outreach, follow-up calls, or care coordination.
Familiarity with chronic conditions such as diabetes, hypertension, cardiovascular disease, and COPD.
Experience working with Medicare patients and care management programs.
Knowledge of hospital discharge procedures and post-discharge patient follow-up.
Skills and Competencies
Excellent bilingual verbal communication skills.
Strong patient service and interpersonal skills.
Basic clinical knowledge and understanding of patient care needs.
Ability to handle sensitive patient information with professionalism and discretion.
Effective time management and follow-through.
Ability to recognize and appropriately escalate urgent patient concerns.
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.
Benefits
401(k)
401(k) matching
Dental insurance
Health insurance
Life insurance
Paid sick time
Paid time off
Vision insurance
Schedule
Evening shift
Monday to Friday
Weekends as needed
Ability To Commute
Essex County, NJ (Preferred)