Customer Service Representative I - Bilingual (24771)
About the position
Responsibilities
• Research, verify and resolve inquiries relating to Oregon Health Plan or Medicare eligibility with guidance from supervisory and leads.
• Respond and assist members with Primary Care Provider (PCP) assignments.
• Learn to collaborate with others inside and outside department to explain benefits not covered by Oregon Health Plan or Medicare and provide information on community resources when appropriate.
• Work collaboratively with providers, DMAP, or members to ensure effective customer service and the resolution of health plan problems (i.e., eligibility and system) as needed.
• Use online Call Tracking system to document all activities from any mode of communication from members, providers and other customers.
• Maintain confidentiality for all members.
• Coordinate mailing of member materials as needed.
• Treat all members with honesty, courtesy, dignity and respect.
• Provide members with professional, timely and competent service.
• Provide proactive, value added service by identifying and reporting system/technology issues.
• Consistently meet or exceed Department and Company standards and expectations including but not limited to quality, production and attendance.
• May assist with outbound calls to Medicaid or Medicare members, which may include welcome and retention calls.
• Propose and implement process improvements.
• Meet deadlines for completion of workload.
• Maintain agreed upon work schedule.
• Demonstrate cooperation and teamwork.
• Provide cross-training on specific job responsibilities.
• Meet identified business goals that contribute to departmental goals.
• Perform other duties as needed.
Requirements
• Minimum 1 year experience required in customer service or health care.
• Fluency through language testing in a second language relevant to the population served.
• Ability to learn and apply Oregon Administrative Rules (OARs), Federal laws and other regulatory agencies that relate to the medical health insurance industry and the Medicaid or Medicare industry.
• Strong computer application skills including MS Windows, Word, Excel and Outlook; comfort navigating through multiple documents and internet browsers.
• Ability to type minimum 35 words per minute.
Nice-to-haves
• Work experience in a call center.
Benefits
• Estimated hiring range $37,610 - $45,970 / year.
• 3% Bilingual Differential.
• 5% bonus target.
• Full benefits.
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