Do you want to work with an expanding team while giving back to the community? We are seeking a Customer Service Representative with strong communication skills and a passion for providing quality healthcare to our members.
What You Will Be Doing:
This role involves being responsible for responding to and resolving a variety of inquiries, requests and issues from external and internal customers in a call center environment.
- Provides information on benefits, eligibility, claims, authorizations, and other related items over the phone and in person.
- Researches and resolves issues related to claims and authorizations, monitors progress.
- Researches and resolves complex eligibility issues, and monitors progress.
- Creates required documentation, including but not limited to call logs and other tracking systems.
What You Bring:
Knowledge, Skills, Abilities and Competencies
- Ability to efficiently and effectively handle calls of heavy volume (50-100 per day), including documentation and resolution.
- Produces work that is accurate and complete.
- Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
- Rebounds from setbacks and adversity when facing difficult situations.
- Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
- Interpersonal skills – interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
- Demonstrates a commitment to HPSJ’s strategy, vision, mission and values.
- Ability to compare and discern the difference between multiple sets of data or information.
- Time management and organizational skills. Uses time effectively and efficiently. Values time.
- Basic skills in Windows, Word, Excel and Outlook.
- Ability to navigate multiple systems and resources simultaneously.
- Ability to type 45 WPM at 90%.
- Ability to handle confidential information with appropriate discretion.
- Ability to speak and be understood in English.
- Knowledge of Medi-Cal programs
- Knowledge of managed care
- Knowledge of medical policy benefits and exclusions
- Knowledge of medical terminology
- Knowledge of ICD and CPT coding.
What you Have:
Education and Experience
- High school diploma or general education degree; and
- At least one of year handling heavy call volume (50-100 calls per day).
At least one of year in a highly customer service facing role (including food service, retail, or similar)
- Associate degree
- Experience in customer service in a health plan, managed care and/or Medi-Cal.
- Fluent in HPSJ key threshold languages (such as Spanish)
What You Will Get:
- HPSJ Perks:
- Competitive salary
- Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
- Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
- CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
- Two flexible spending accounts (FSAs)
- Employer-Paid Term Life and AD&D Insurance
- Employer-Paid Disability Insurance
- Employer-Paid Life Assistance Program
- Health Advocacy
- Supplemental medical, legal, identity theft protection
- Access to exclusive discount mall
- Education and training reimbursement in addition to employer-paid elective learning courses.
- A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
- A shorter commute – if you’re commuting from the Central Valley to the Bay Area.
- Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.
- Continuously improve the health of our community.
- We provide healthcare value and advance wellness through community partnerships.
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