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Customer Service Representative I
2 months ago
We are seeking a highly skilled and compassionate Customer Service Representative I to join our team at Santa Clara County Health Plan. As a key member of our Customer Service Department, you will play a vital role in providing exceptional service to our members and providers.
Key Responsibilities- Member Support: Respond to inbound calls and make outbound calls to support our members and providers, ensuring that their inquiries and concerns are addressed in a timely and professional manner.
- Communication and Documentation: Develop a thorough understanding of our member-facing materials, communications, and interactions, and be prepared to respond to follow-up calls. Accurately document all contacts and follow-up actions in accordance with established guidelines.
- Problem-Solving and Resolution: Use listening skills and judgment to categorize and resolve member and provider inquiries and concerns in a fair and timely manner. Escalate issues to the Grievance and Appeals department when necessary.
- Education and Training: Educate members and providers on eligibility, medical and pharmacy benefits, and how to access services in a manner that achieves excellent service standards and maintains high customer satisfaction.
- Team Collaboration: Work collaboratively with other departments to ensure seamless communication and resolution of member and provider issues.
- Education: High School Diploma or GED.
- Experience: Minimum one year of experience in Customer Service or a Call Center role, preferably within a Health Care, Public Assistance, or Human Services program.
- Language Skills: Spanish, Vietnamese, Chinese, or Tagalog language bi-lingual skills are highly desirable.
- Technical Skills: Working knowledge of and the ability to efficiently operate all applicable computer software, including computer applications such as Outlook, Word, and Excel.
- Communication and Interpersonal Skills: Excellent communication skills, including the ability to express oneself clearly and concisely when providing service to members and providers.
- Problem-Solving and Analytical Skills: Ability to think and work effectively under pressure, accurately prioritize and complete tasks within established timeframes, and make decisions within the scope of the position.
This role is primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.
Physical Requirements- Mobility Requirements: Regular bending at the waist, and reaching overhead, above the shoulders, and horizontally, to retrieve and store files and supplies, and sit or stand for extended periods of time.
- Lifting Requirements: Regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds.
- Visual Requirements: Ability to read information in printed materials and on a computer screen, perform close-up work, and clarity of vision is required at 20 inches or less.
- Dexterity Requirements: Regular use of hands, wrists, and finger movements, ability to perform repetitive motion (keyboard), writing (note-taking), and ability to operate a computer keyboard and other office equipment.
- Hearing/Talking Requirements: Ability to hear normal speech, hear and talk to exchange information in person and on telephone.
