Job Description

OUR CLIENT IS AN AMERICAN FOR-PROFIT MANAGED HEALTH CARE COMPANY, FOCUSED ON SPECIAL POPULATIONS, COMPLETE PHARMACY BENEFITS AND OTHER SPECIALTY AREAS OF HEALTHCARE SEEKS BILINGUAL CUSTOMER CARE ASSOCIATE.

POSITION: BILINGUAL CUSTOMER CARE ASSOCIATE

LOCATION: RANCHO CORDOVA, CA (WORK FROM HOME TILL YEAR-END DUE TO THE CURRENT COVID-19 SITUATION, EQUIPMENT WILL BE PROVIDED)

DURATION: TEMP TO PERM

PAY: $18/HR ON W2

RELOCATION ASSISTANCE/ EXPENSES: NO

JOB RESPONSIBILITIES:

• Answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers.
• Responsibilities also include the administration of intake documentation into the appropriate systems.
• Overall expectations to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call.
• Performance expectations are to meet or exceed operations production and quality standards.
• Listens and probes callers in a professionally and timely manner to determine purpose of the calls.
• Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
• Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
• Assist efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
• Assist in the mentoring and training of new staff.
• Assume full responsibility for self-development and career progression; proactively seek and participate in ongoing trainings (formal and informal).
• Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
• Demonstrate flexibility in areas such as job duties and schedule in order to aid in better serving members and help achieve its business and operational goals.
• Educates providers on how to submit claims and when/where to submit a treatment plan.
• Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved.
• Informs providers and members on Client’s appeal process.
• Lead or participate in activities as requested that help improve Care Center performance, excellence and culture.
• Links or makes routine referrals and triage decisions not requiring clinical judgment.
• Performs necessary follow-up tasks to ensure member or provider's needs are completely met.
• Provides information regarding Client’s in-network and out-of-network reimbursement rates and states multiple networks to providers.
• Refers callers requesting provider information to Provider Services regarding Client’s professional provider selection criteria
• and application process.
• Refers patients/EAP clients to the Client’s Care Management team for a provider, EAP affiliate, or Facility.
• Responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers.
• Support team members and participate in team activities to help build a high-performance team.
• Thoroughly documents customers comments/information and forwards required information to the appropriate staff.

REQUIREMENTS:

• Must be bilingual.
• Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.
• Responsible for meeting call handling requirements and daily telephone standards as set forth by management.
• Must agree to observing service for the purpose of training and quality control.
• Proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
• Must be able to maneuver through various computer platforms while verifying information on all calls.
• Must be able to talk and type simultaneously

Company Description

Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally; as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients’ businesses forward. Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws.