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Customer Service Representative
1 month ago
Sr. Customer Service Representative Job Description
Hourly Rate: $23.92 - $33.48/hr
Offer will be made by the client based upon experience
Fully on-site; Monday- Friday
Job Summary
One of our most prestigous healthcare clients is seeking a highly motivated an experienced TEMP - Customer Service Representative Sr.
Must be Bilingual
The Customer Service Representative Sr. (CSR Sr.) will serve as a senior point of contact for OneCare members and providers and will assist them with questions and/or complaints related to the OneCare plan services. The incumbent will provide information regarding eligibility, enrollment, benefits and services to OneCare eligible members and providers.
Position Information:
- Department: Customer Service
- Salary Grade: $23.92 - $33.48/hr
- Work Arrangement: Full Office
Duties & Responsibilities:
- 95% - Program Support 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 and provider inquiries, questions and concerns in all areas, including eligibility, enrollment, claims or authorization status, benefit interpretation and referrals/authorizations for medical care in-person or telephonically. Serves as a senior resource for other team members (i.e., solves complex challenges, answers uncommon questions and shares complex processes and procedures). Supports in the coordination of member’s health care and social service needs both within and outside the medical group and the client. Enters accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction. Initiates referrals to both internal and external care management departments and other department/government or community agencies. 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. Provides additional follow-up assistance as needed.
- 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 and provider inquiries, questions and concerns in all areas, including eligibility, enrollment, claims or authorization status, benefit interpretation and referrals/authorizations for medical care in-person or telephonically.
- Serves as a senior resource for other team members (i.e., solves complex challenges, answers uncommon questions and shares complex processes and procedures).
- Supports in the coordination of member’s health care and social service needs both within and outside the medical group and the client.
- Enters accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction.
- Initiates referrals to both internal and external care management departments and other department/government or community agencies.
- 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. Provides additional follow-up assistance as needed.
- 5% - Completes other projects and duties as assigned.
Minimum Qualifications:
- High School diploma or equivalent required.
- 2 years of experience in customer/member service, including 1 year call center capacity required.
- Typing speed of 35 words per minute (WPM) required.
- An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
- Bilingual in English and in one of the defined threshold languages (Arabic, Chinese, Farsi, Korean, Spanish, Vietnamese) required.
Preferred Qualifications:
- 1 year of Health Maintenance Organization (HMO), Medi-Cal/Medicaid and health services experience.
Required Licensure / Certifications:
- n/a
Knowledge & Abilities:
- Develop rapport and establish and maintain effective working relationships with leadership and staff and external contacts at all levels and with diverse backgrounds.
- 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.
- Work in a fast-paced environment and in an efficient manner.
- Manage multiple projects and identify opportunities for internal and external collaboration.
- Motivate and lead multi-program teams and external committees/coalitions.
- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With or Without Accommodations):
- Ability to visually read information from computer screens, forms and other printed materials and information.
- Ability to speak (enunciate) clearly in conversation and general communication.
- Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
- Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
- Lifting and moving objects, patients and/or equipment 10 to 25 pounds
