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Customer Service Representative
1 month ago
TiTle: Customer Service Representative (Bilingual)
Location: Orange, CA
Onsite
Job Description :
The client is seeking a highly motivated an experienced TEMP - Customer Service Representative Sr (OneCare-Bilingual Required) (6) to join our team. 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.
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.
- 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.
- 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 client's 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.