The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
Join our team! We are hiring a Customer Service Representative for our French Camp office. This is a fully onsite position.
Training Schedule: Monday to Friday from 8:00 to 4:30
After Training: Monday to Friday from 8:00 to 5
At this time, the Health Plan does not sponsor visa. Candidates must have legal and valid work authorization, Green Card, or U.S. citizenship .
What You Will Be Doing:
Under direct supervision, the Customer Service Rep is responsible for responding to and resolving a variety of inquiries, requests and issues from external and internal customers in a call center environment.
Our Vision:
Continuously improve the health of our community.
Our Mission:
We provide healthcare value and advance wellness through community partnerships.
Essential Functions:
- 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; monitors progress.
- Creates required documentation, including but not limited to call logs and other tracking systems.
What You Bring:
Knowledge, Skills, Abilities and Competencies
Required
- 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.
- 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 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.
- Must type 40 WPM.
- Must pass Call Center Listening Skill test with a score of 71+.
Preferred
- Ability to efficiently and effectively handle calls of heavy volume (50-100 per day), including documentation and resolution.
- Knowledge of Medi-Cal programs
- Knowledge of Medicare DSNP programs
- Knowledge of managed care
- Knowledge of medical policy benefits and exclusions
- Knowledge of medical terminology
- Knowledge of ICD and CPT coding.
What You Have:
Education and Experience
Required
- High school diploma or general education degree; and
- Customer Service experience.
Preferred
- Associate’s Degree
- Experience in customer service in a health plan, managed care, Medicare DSNP and/or Medi-Cal.
- At least one year handling heavy call volume (50-100 calls per day).
Licenses, Certifications
None.
What You Will Get:
HPSJ Perks:
- Competitive salary
- Robust and affor