2 VHP Member Services Representative Jobs in San Jose, CA
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County of Santa Clara is Hiring a VHP Member Services Representative Near San Jose, CA
Under limited supervision to respond in a timely, accurate and courteous manner to the inquiries and concerns of the health plan members and the general public. The VHP Member Services Representative is the primary liaison between the health plan member, network providers and the health plan.
Valley Health Plan Member Services is hiring three (3) VHP Member Service Representative positions that will be working in both VHP’s office's located in San Jose to support Santa Clara County members, and Salinas to support San Benito and Monterey County members.
Candidates who meet the employment standards will be invited to take an online written examination tentatively scheduled for the week of June 5, 2024. The examination instructions will be sent via the email address attached to your application.Learn more about Valley Health Plan at www.valleyhealthplan.org and follow us on:
Facebook | facebook.com/valleyhealthplanInstagram | instagram.com/valleyhealthplanYouTube | youtube.com/user/valleyhealthplanLinkedIn | linkedin.com/company/valley-health-plan
- Answers phone; screens and refers callers;
- Provides members and providers with information about the VHP network, health plan options and benefits;
- Educates members about proper use of the health plan;
- Assists members with benefit interpretation registration, and new enrollment;
- Serves as liaison or advocate between the member and network providers or other departments within VHP;
- Assists with the management of complaints and grievances in accordance with the policies and procedures;
- Identifies, addresses and documents member/provider issues and trends in order to achieve member satisfaction;
- Maintains and reports information on members and services as required;
- Maintains, organizes and updates member related files;
- Assists in conducting member satisfaction surveys and reports;
- Types a wide variety of forms, documents and correspondence using computer programs;
- Initiates and composes letters, and memos;
- Reconciles and corrects discrepancies payment for groups that VHP provides coverage to;
- Maintains proper inventory of handbooks and manuals;
- Performs other related duties as required.
Experience Note: A candidate would normally acquire the knowledge and abilities listed below by attaining two (2) years of work experience as a Health Services Representative, medical receptionist or Customer Services Representative in a managed care or health maintenance organization.
Knowledge of:
- Basic medical office practices and procedures;
- Interviewing techniques and telephone etiquette;
- Basic medical terminology;
- Medical billing;
- Proper English usage, style grammar, punctuation and spelling;
- Medi-Cal Managed Care protocols;
- General policy of health coverage limits related to managed care and HMO standards;
- Purpose and use of International Classification of Disease Standards;
- Purpose and use of the Concurrent Procedure Terminology;
- Computer and software usage including use of databases and word processing programs.
- Perform a variety of clerical duties and work effectively under stressful conditions;
- Type with moderate speed and accuracy;
- Organize and manage detail effectively;
- Work with a culturally diverse patient population;
- Work independently, establish work priorities and meet deadlines;
- Utilize effective interpersonal and problem-solving skills;
- Use a keyboard with moderate speed and accuracy.
Job Summary
Full Time
$44k-53k (estimate)
06/10/2023
05/17/2024
sccgov.org
SAN JOSE, CA
7,500 - 15,000
2016
JEFFREY V SMITH
$1B - $3B
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About County of Santa Clara
The goal of the Office of LGBTQ Affairs is to provide leadership, accountability, and effective outcomes across programs and departments for the well-being and longevity of LGBTQ communities throughout Santa Clara County. It aims to provide targeted training for client-specific needs and employee-related LGBTQ issues. The Office identify gaps in services to LGBTQ residents, develops resources to address them, and devises evaluation metrics to determine the effectiveness of those efforts. The Office of LGBTQ Affairs plays a role in convening community stakeholders and promoting and collaboratin...g on LGBTQ community events, including those that foster dialogue and increase access to services for the most disenfranchised members of the LGBTQ community. To contact The Office of LGBTQ Affairs staff please send email: lgbtq@ceo.sccgov.org. Location: 2460 North First Street, Suite 220 San Jos, CA 95131 Phone: (408) 678-2900 Email: lgbtq@ceo.sccgov.org
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