Customer Service Representative - Orange, United States - Infojini

Description

Duties & Responsibilities:

• 80% - Program Support
• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Maintains departmental productivity and quality standards.
• Follows through on and completes all member and provider inquiries or requests during the original member and provider interaction.
• Serves as a resource for other team members.
• 15% - Administrative Support
• Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.
• Addresses 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.
• Communicates, builds and maintains internal and external relationships by prompt and accurate service delivery.
• Identifies and communicates challenges that might arise with the use of professional judgment while adhering to departmental policies and procedures.
• 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.
• Typing speed of 35 words per minute (WPM) 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.

Preferred Qualifications:

• 6 months of Medi-Cal/Medicaid or health services experience.

Required Licensure / Certifications:

• N/A

Knowledge & Abilities:

• Develop rapport and establish and maintain effective working relationships with 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.