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Customer Service Representative
2 months ago
We are seeking a highly skilled and customer-focused Customer Service Representative to join our Member Services team in Northridge. As a key member of our team, you will be responsible for providing exceptional service to our members, health plans, providers, and employer groups.
Key Responsibilities- Respond to telephone inquiries from members, health plans, providers, and employer groups to provide information and clarification relating to RMG services.
- Maintain or exceed quality and productivity standards of a minimum of 65 calls per day with matching documentation.
- Anticipate customer needs, understand their wants and needs, and identify how to respond and determine what level of intervention they may need.
- Utilize standardized processes, tools, and resolve routine or complex issues relating to services provided by a provider within the medical group.
- Maintain patient confidentiality and observe HIPAA compliance at all times.
- Process member demographic updates and handle designated assignments and prioritize work to maintain workflow.
- Perform fax functions as needed and ensure written and verbal communication with all levels of management, staff, vendors, and property management is accurate and with good grammar.
- Display professionalism, warm, and pleasant phone personality, emphasizing tact, empathy, good judgment, and patience.
- Minimum two (2) years of customer service and public relations experience in a medical setting.
- High School Diploma or equivalent is required.
- Ability to deal responsibly with matters of a confidential nature.
- Ability to multi-task and meet deadlines in a high-stress environment.
- Must have excellent communication skills, both verbal and written.
- Ability to read, write, and understand the English language.
- Pleasant telephone manner and telephone etiquette.
- The ability to distinguish the differences between CPT, HCPCS, Revenue, and ICD coding.
- Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access, and PowerPoint).
- Knowledge of computers, faxes, printers, and all other office equipment.
- Self-starter, willing to take on multiple tasks.
- Must be able to review and interpret health plan benefits and provider contracts.
- Able to interface with customers both internal and external of RMG.
- Typing 45 WPM with accuracy.
- Ability to communicate effectively orally and written answering and resolving a minimum of 65 calls per day with matching documentation.
- Strong organizational skills with emphasis on prioritizing and attention to details.
- Managed Care experience is a plus.
- Bilingual is a plus: Farsi, Armenian, Tagalog, Vietnamese, Russian.
We offer a comprehensive benefits package, including health and wellness benefits, savings and retirement plans, and other benefits that support your overall well-being. Our benefits package includes:
- Employer-paid comprehensive medical, pharmacy, and dental for employees.
- Vision insurance.
- Zero co-payments for employed physician office visits.
- Flexible Spending Account (FSA).
- Employer-Paid Life Insurance.
- Employee Assistance Program (EAP).
- Behavioral Health Services.
We are an equal opportunity employer and welcome applications from qualified candidates with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.
