Customer Support Specialist II

1 week ago

Seattle, Washington, United States Community Health Plan of Washington Full time

Customer Service Rep II

Job Category: Customer Experience

Requisition Number: CUSTO01561

Job Details

Overview

The Customer Service Rep II plays a vital role in delivering exceptional support to members and providers. This position is responsible for addressing inquiries related to benefits, eligibility, claims status, and accessing care through our network of providers.

Key Responsibilities:

  1. Respond promptly and courteously to member and provider inquiries, ensuring accurate information is provided.
  2. Facilitate the resolution of issues and complaints, coordinating with relevant departments as necessary.
  3. Document all inquiries and complaints in the database with clarity and precision.
  4. Support other team members and functional areas as needed.
  5. Maintain attendance and quality standards, striving for continuous improvement in customer service skills.
  6. Achieve first call resolution to enhance customer satisfaction.
  7. Contribute to a cohesive team environment focused on delivering outstanding customer service.
  8. Perform additional duties as assigned, adapting to the evolving needs of the organization.

Qualifications

Education:

A high school diploma or equivalent is required. Some college or vocational training is preferred.

Experience:

A minimum of 2 years of experience in customer service is required, ideally within insurance, managed care, or a healthcare provider setting. Experience in a call center environment is strongly preferred, along with knowledge of claims processing and familiarity with state and federal programs such as Medicaid and Medicare Advantage Plans.

Skills and Abilities:

  • Understanding of state and federal healthcare programs is preferred.
  • Proficiency in languages such as Spanish and Vietnamese is advantageous.
  • Familiarity with medical terminology and healthcare practices is preferred.
  • Strong written communication skills, with the ability to summarize information clearly.
  • Flexibility to work in a dynamic, matrix-management environment.
  • Ability to manage multiple tasks and complex assignments effectively.
  • Commitment to accuracy, attention to detail, and adherence to established timelines.
  • Professionalism and confidentiality in all interactions.
  • Capacity to work independently while contributing to a fast-paced team.

Work Environment:

This role is situated in an office environment, which may involve exposure to low-grade radiation from computer monitors. The pace is fast, with frequent interruptions.

Protected Health Information (PHI) Access:

All employees may encounter confidential information in the course of their duties and must adhere to all relevant policies and regulations.

Equal Opportunity Employer:

Community Health Plan of Washington is committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any protected characteristic.

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