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Customer Service Representative, Lead

1 month ago

Placerville, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time
Job DescriptionJob DescriptionThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

We are currently hiring a Customer Service Representative Lead to join our team onsite in Placerville, CA

What You Will Be Doing:

Under direct supervision, responsible for responsible for coordinating the daily operations of the customer service team in partnership with supervisors, in a manner that supports consistent and accurate job performance.

  • Provides information on benefits, eligibility, claims, authorizations, and other related items over the phone and in person.
  • Researches and resolves and/or escalates reported issues.
  • Researches and resolves complex eligibility and other issues.
  • Creates and maintains required documentation, including but not limited to call logs and other tracking systems.
  • Assists team members, including but not limited to providing information, and assisting with complex, sensitive or other service issues; accepts and resolves supervisor and escalated member calls, or other calls as required.
  • Conducts call monitoring and coaching on assigned calls.
  • Assists with coordination of staff assignments, including managing the call queue.

What You Bring:

Required:

  • Ability to handle calls of heavy volume (50-100 per day) efficiently and effectively, including documentation and resolution. 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, with appropriate grammar and spelling, 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.
  • Strong organizational skills, with the ability to effectively prioritize and complete multiple tasks and prioritize tasks for others.
  • Basic problem solving and analytical skills, with ability to resolve problems of minimal complexity and scope.
  • Basic leadership skills, including but not limited to the ability to influence without authority and motivate others.
  • Commitment to and ability to facilitate the adoption of HPSJ’s strategy, vision, mission, and values.
  • Basic knowledge of audit and QA processes and protocols.
  • Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.
  • In-depth knowledge of procedure coding and medical terminology and their application to benefits.
  • In-depth knowledge of Medi-Cal regulations, benefits, and payment practices as they relate to customer service.
  • In-depth knowledge of health plan functions as they relate to customer service.
  • Basic problem solving and analytical skills, including the ability to perform routine analysis and solve problems using identified data and information.
  • Basic arithmetic skills.
  • Intermediate skills in Windows, Word, Excel, and Outlook.
  • In-depth knowledge of call center systems.
  • 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.

Preferred:

  • None.

What you Have:

Education and Experience

Required:

  • High school diploma or general education degree; and
  • At least one year handling heavy call volume (50-100 calls per day); and
  • At least two years as a customer service representative or similar role in a health plan serving Medi-Cal beneficiaries; and
  • Experience using multiple customer service systems.

Preferred:

  • Associate degree.

What You Will Get:

HPSJ Perks:

  • Competitive salary
  • Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
  • Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
  • CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
  • Two flexible spending accounts (FSAs)
  • Employer-Paid Term Life and AD&D Insurance
  • Employer-Paid Disability Insurance
  • Employer-Paid Life Assistance Program
  • Health Advocacy
  • Supplemental medical, legal, identity theft protection
  • Access to exclusive discount mall
  • Education and training reimbursement in addition to employer-paid elective learning courses.
  • A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
  • A shorter commute ­– if you’re commuting from the Central Valley to the Bay Area.
  • Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.

Our Vision:

Continuously improve the health of our community.

Our Mission:

We provide healthcare value and advance wellness through community partnerships.

We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.

HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics, or is associated with anyone who has or is perceived to have these characteristics.

Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.