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Customer Service Representative

2 months ago


Chula Vista, California, United States Community Health Group Full time
Job Summary

We are seeking a highly skilled and compassionate Customer Service Representative to join our team at Community Health Group. As a key member of our Member Services department, you will play a vital role in delivering exceptional customer service to our members, ensuring their needs are met and exceeded.

Responsibilities
  • Resolve member concerns through strategic actions, ensuring swift and seamless access to urgent care, interpreter services, and transportation arrangements.
  • Facilitate smooth transitions for members, including changes in primary care providers and site discharges.
  • Document all interactions meticulously, providing issue statements, steps taken for resolution, and resolution outcomes.
  • Collaborate with cross-functional departments to ensure comprehensive member care and provider/vendor support.
  • Engage with community-based programs to address members' non-medical and social needs.
  • Represent the company in a highly professional manner at various events and forums.
  • Adhere to on-call schedules, established procedures, and seek opportunities for service enhancement.
  • Contribute to achieving departmental objectives, including exceptional customer service, complaint resolution, and member retention.
  • Exhibit unwavering dedication to delivering superior, culturally sensitive service to team members, providers, and external partners.
  • Initiate and ensure continuity of care for members eligible for such services.
  • Uphold telephone service standards by actively participating in incoming Member Services telephone lines.
  • Embrace various duties and participate in special projects as required.
Requirements
  • Bachelor's Degree
  • Two years of experience in Member Services (preferably in the healthcare industry)
  • Strong customer service background
  • Familiarity with case documentation practices
  • Experience with and sensitivity to cultural background and linguistic needs of membership
  • Familiarity with Medi-Cal program eligibility requirements and community-based ethnic service and advocacy organizations
  • Bilingual English/Spanish, English/Vietnamese, or English/Arabic
  • Excellent communication and interpersonal skills
  • Ability to exercise mature and independent judgment
Physical Requirements

Prolonged periods of sitting. Extensive use of telephone. Will be required to work evenings and/or weekends.

Community Health Group is an equal opportunity employer committed to diversity and inclusion in the workplace.