Customer Service Representative I - Bilingual (24771)
About the position Responsibilities • Research, verify and resolve inquiries relating to Oregon Health Plan or Medicare eligibility with guidance from supervisory and leads. • Respond and assist members with Primary Care Provider (PCP) assignments. • Learn to collaborate with others inside and outside department to explain benefits not covered by Oregon Health Plan or Medicare and provide information on community resources when appropriate. • Work collaboratively with providers, DMAP, or members to ensure effective customer service and the resolution of health plan problems (i.e., eligibility and system) as needed. • Use online Call Tracking system to document all activities from any mode of communication from members, providers and other customers. • Maintain confidentiality for all members. • Coordinate mailing of member materials as needed. • Treat all members with honesty, courtesy, dignity and respect. • Provide members with professional, timely and competent service. • Provide proactive, value added service by identifying and reporting system/technology issues. • Consistently meet or exceed Department and Company standards and expectations including but not limited to quality, production and attendance. • May assist with outbound calls to Medicaid or Medicare members, which may include welcome and retention calls. • Propose and implement process improvements. • Meet deadlines for completion of workload. • Maintain agreed upon work schedule. • Demonstrate cooperation and teamwork. • Provide cross-training on specific job responsibilities. • Meet identified business goals that contribute to departmental goals. • Perform other duties as needed. Requirements • Minimum 1 year experience required in customer service or health care. • Fluency through language testing in a second language relevant to the population served. • Ability to learn and apply Oregon Administrative Rules (OARs), Federal laws and other regulatory agencies that relate to the medical health insurance industry and the Medicaid or Medicare industry. • Strong computer application skills including MS Windows, Word, Excel and Outlook; comfort navigating through multiple documents and internet browsers. • Ability to type minimum 35 words per minute. Nice-to-haves • Work experience in a call center. Benefits • Estimated hiring range $37,610 - $45,970 / year. • 3% Bilingual Differential. • 5% bonus target. • Full benefits. Apply tot his job