Do you want to work with an expanding team while giving back to the community? We are seeking a Customer Service Representative with strong communication skills and a passion for providing quality healthcare to our members.
WHAT YOU WILL BE DOING:
This role involves being responsible for responding to and resolving a variety of inquiries, requests and issues from external and internal customers in a call center environment.
- Provides information on benefits, eligibility, claims, authorizations, and other related items over the phone and in person.
- Researches and resolves issues related to claims and authorizations, monitors progress.
- Researches and resolves complex eligibility issues, and monitors progress.
- Creates required documentation, including but not limited to call logs and other tracking systems.
Required Skills
WHAT YOU BRING:
KNOWLEDGE, SKILLS, ABILITIES AND COMPETENCIES
Required
- Ability to efficiently and effectively handle calls of heavy volume (50-100 per day), including documentation and resolution.
- Produces work that is accurate and complete.
- Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
- Rebounds from setbacks and adversity when facing difficult situations.
- Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
- Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
- Strong oral and written communication skills, with ability to express self clearly and professionally, and document according to standards.
- Strong listening skills, with the ability to accurately receive and understand messages.
- Basic conflict resolution skills, with the ability to use tact and diplomacy to diffuse emotional situations.
- Ability to work independently and as part of a team.
- Demonstrates a commitment to HPSJ’s strategy, vision, mission and values.
- Ability to read, understand and apply complex written guidelines, instructions and other materials.
- Ability to compare and discern the difference between multiple sets of data or information.
- Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.
- Basic problem solving and analytical skills, including the ability to perform routine analysis and solve problems using identified data and information.
- Basic arithmetic skills.
- Basic knowledge of contact center systems.
- Basic skills in Windows, Word, Excel and Outlook.
- Ability to navigate multiple systems and resources simultaneously.
- Ability to type 45 WPM at 90%.
- Ability to handle confidential information with appropriate discretion.
- Ability to speak and be understood in English.
- Proficiency (as defined by HPSJ’s Cultural and Linguistics Program) in one of HPSJ’s threshold languages may be required, depending on business requirements.
Preferred
- Knowledge of Medi-Cal programs
- Knowledge of managed care
- Knowledge of medical policy benefits and exclusions
- Knowledge of medical terminology
- Knowledge of ICD and CPT coding.
Required Experience
WHAT YOU BRING:
KNOWLEDGE, SKILLS, ABILITIES AND COMPETENCIES
Required
- Ability to efficiently and effectively handle calls of heavy volume (50-100 per day), including documentation and resolution.
- Produces work that is accurate and complete.
- Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
- Rebounds from setbacks and adversity when facing difficult situations.
- Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
- Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
- Strong oral and written communication skills, with ability to express self clearly and professionally, and document according to standards.
- Strong listening skills, with the ability to accurately receive and understand messages.
- Basic conflict resolution skills, with the ability to use tact and diplomacy to diffuse emotional situations.
- Ability to work independently and as part of a team.
- Demonstrates a commitment to HPSJ’s strategy, vision, mission and values.
- Ability to read, understand and apply complex written guidelines, instructions and other materials.
- Ability to compare and discern the difference between multiple sets of data or information.
- Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.
- Basic problem solving and analytical skills, including the ability to perform routine analysis and solve problems using identified data and information.
- Basic arithmetic skills.
- Basic knowledge of contact center systems.
- Basic skills in Windows, Word, Excel and Outlook.
- Ability to navigate multiple systems and resources simultaneously.
- Ability to type 45 WPM at 90%.
- Ability to handle confidential information with appropriate discretion.
- Ability to speak and be understood in English.
- Proficiency (as defined by HPSJ’s Cultural and Linguistics Program) in one of HPSJ’s threshold languages may be required, depending on business requirements.
Preferred
- Knowledge of Medi-Cal programs
- Knowledge of managed care
- Knowledge of medical policy benefits and exclusions
- Knowledge of medical terminology
- Knowledge of ICD and CPT coding.