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Customer Service Representative

Health Plan of San Joaquin

Customer Service Representative

French Camp, CA +1 location
Full Time
Paid
  • Responsibilities

    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 HAVE:

    EDUCATION AND EXPERIENCE

    Required

    • High school diploma or general education degree; and
    • At least one of year handling heavy call volume (50-100 calls per day).

    Preferred

    • Associate degree
    • Experience in customer service in a health plan, managed care and/or Medi-Cal.

     

    WHAT YOU WILL GET:

    • HPSJ Perks:
      • Competitive salary
      • Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
      • Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
      • CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
      • Two flexible spending accounts (FSAs)
      • Employer-Paid Term Life and AD&D Insurance
      • Employer-Paid Disability Insurance
      • Employer-Paid Life Assistance Program
      • Health Advocacy
      • Supplemental medical, legal, identity theft protection
      • Access to exclusive discount mall
      • Education and training reimbursement in addition to employer-paid elective learning courses.
    • A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
    • A shorter commute ­– if you’re commuting from the Central Valley to the Bay Area.
    • Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.

     

     

    OUR VISION:

    • Continuously improve the health of our community.

     

    OUR MISSION:

    • We provide healthcare value and advance wellness through community partnerships.
  • Qualifications

    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.
  • Locations
    French Camp, CA • Modesto, CA