What are the responsibilities and job description for the Customer Service Representative position at 9992?
Title - Customer Service Representative
Client - CalOptima
Duration - 6-8 months
Pay- $25/HR
Location - 05 City Parkway West Orange CA
Duties & Responsibilities:
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95% - Program Support
Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.
Guides members in understanding and accessing the benefits they are entitled to under Medicare and Medi-Cal, through the OneCare program.
Address member and provider inquiries, questions and concerns in all areas including eligibility, enrollment, claims or authorization status, benefit interpretation and referrals/authorizations for medical care in-person or telephonically.
Enters accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction.
Initiates referrals to both internal/external care management departments and other departments, governments or community agencies.
Participates in departmental phone outreach campaigns on a regular basis.
5% - Completes other projects and duties as assigned.
Minimum Qualifications:
High school diploma or equivalent required. 6 months of experience in a call center capacity required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese) required.
Preferred Qualifications:
6 months of health maintenance organization (HMO), Medi-Cal/Medicaid and health services experience.
Typing speed of 35 words per minute (WPM).
Required Licensure / Certifications:
n/a
Knowledge & Abilities:
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
Work independently and exercise sound judgment.
Communicate clearly and concisely, both orally and in writing.
Work a flexible schedule; available to participate in evening and weekend events.
Organize, be analytical, problem-solve and possess project management skills.
Work in a fast-paced environment and in an efficient manner.
Manage multiple projects and identify opportunities for internal and external collaboration.
Motivate and lead multi-program teams and external committees/coalitions.
Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Salary : $24 - $25
