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Costa Mesa

    Senior Customer Service Representative - Costa Mesa, United States - AlohaCare

    AlohaCare
    AlohaCare Costa Mesa, United States

    2 weeks ago

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    Description

    Job Description

    Job Description

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    The Company:

    AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii's third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.

    The Culture:

    AlohaCare employees share a passion for helping Hawaii's most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication and a generous benefits package.

    AlohaCare's leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii's families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare's comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

    These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.

    The Opportunity/Position Summary:

    The Senior Customer Service Representative provides in/outbound telephonic and occasional face to face service to AlohaCare members and providers, using the highest degree of expertise, courtesy and professionalism with the objective of retaining the customer's business and ensuring their on-going satisfaction in service.

    Essential Duties & Responsibilities of the Senior Customer Service Representative :

    • Fields incoming member and provider routine and complex calls concerning benefits, services, claims and other inquiries.
    • Receives and completes member call backs regarding various company surveys, reminders or mailers.
    • Assists members in Primary Care Physician (PCP) selections and reassignments in accordance with regulatory agency and AlohaCare policies, and updates member records as needed
    • Responds to all incoming inquires relating to member eligibility and assists members in enrollment into the QUEST Integration program.
    • Maintains data integrity by entering and updating information in member and provider database; keeping accurate account of all telephonic transactions.
    • At the minimum, work physically in the office full time at 3090 Bristol Street, Costa Mesa, CA 92626 during the first 90 days of training.
    • Position is hybrid.
    • Responsible to maintain AlohaCare's confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.

    Required Competencies & Qualifications of the Senior Customer Service Representative :

    • High School graduate / equivalent
    • Minimum of 2 years of call center work experience
    • Minimum of 2 years health care work experience
    • Working knowledge of Microsoft Office (Outlook, Word Excel and Lync)

    Preferred Qualifications of the Senior Customer Service Representative:

    • Associate degree or post high school graduate training – especially in healthcare, insurance or customer service related fields
    • Prior managed care work experience

    Physical Demands/Working Conditions:

    • Requires prolonged operation of a computer workstation, including the ability to type for extended periods of time on a keyboard during the scheduled work day.
    • May require occasional lifting, up to 20 pounds

    Salary Range: $ $25.000 an hour

    AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. We are an equal opportunity employer. All persons shall have the opportunity to be considered for employment without regard to their actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, related medical conditions and lactation), gender identity or expression (including transgender status), sexual orientation, marital status, military service and veteran status, disability, protected medical condition as defined by applicable state or local law, genetic information or any other characteristic protected by applicable federal, state or local laws and ordinances.

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