Title : Customer Service Rep (Non-Bilingual)

Duration : Temp up to 6 months

Compensation : $20.81-$29.71

In Office

Description : The Customer Service Representative Sr is the first line of contact for Health Plan members and providers and will assist them with questions related to the Medi-Cal programs for Orange County.

The incumbent resolves member inquiries and complaints fairly and effectively. The incumbent provides information regarding eligibility, enrollment, benefits and services to Health Plans eligible members and providers.

What You Will Do :

• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals / priorities for the department.
• Addresses member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals / authorizations for medical care.
• Maintains departmental productivity and quality standards.
• Follows through on and completes all member and provider inquiries or requests during the original member and provider interaction.
• Serves as a resource for other team members.
• Enters accurate and complete documentation into internal application systems regarding all concerns and / or inquiries from the member and provider interaction.
• Communicates, builds and maintains internal and external relationships by prompt and accurate service delivery.
• Identifies and communicates challenges that might arise with the use of professional judgment while adhering to departmental policies and procedures.
• Completes other projects and duties as assigned.

You Will Be Successful If :

• Establish and maintain effective working relationships with leadership and staff.
• Function efficiently and productively in a high-volume call center.
• Learn procedures and regulations governing member eligibility and the terminology and documents used while remaining knowledgeable of Medi-Cal benefits and procedures.
• Utilize computer and appropriate software (e.g., Microsoft Office : Word, Outlook, Excel, PowerPoint) and job specific applications / systems (e.

g., Facets) to produce correspondence, charts, spreadsheets, and / or other information applicable to the position assignment.

• Motivate and lead multi-program teams and external committees / coalitions.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Principles and techniques for handling customer service issues.
• Personal computers, keyboarding, and appropriate software to produce correspondence, charts, spreadsheets, and / or other information applicable to the position assignment.

What You Will Bring :

• High School diploma or equivalent required.
• 6 months of experience in customer / member service or call center capacity required.
• Typing speed of 35 words per minute (WRM) required
• An equivalent combination of education and experience is sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• 6 months of Medi-Cal / Medicaid or health services experience preferred.

About Impresiv Health :

Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services.

We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.

Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do provide tangible results that add immediate value, at a rate that cannot be beaten.

Your success matters, and we know it.

That's Impresiv!

Last updated : 2024-05-20