Customer Service Representative – Health Plan of San Joaquin – French Camp, CA

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.

Required Skills


What You Bring:


Knowledge, Skills, Abilities and Competencies

Required

  • 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.

Preferred

  • 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.

Required Experience


What you Have:


Education and Experience

Required

  • 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)

Preferred

  • 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.


Our Vision:

  • Continuously improve the health of our community.


Our Mission:

  • We provide healthcare value and advance wellness through community partnerships.

Source: Indeed.com
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