Customer Service Representative Bilingual - Healthcare Provider
Customer Service Representative Bilingual - Healthcare Provider
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1-3years
$ $ 25 - 27
1 Vacancy
Job Description
Customer Service Representative Sr. (Bilingual)
Company Overview: Our client is a leading healthcare located in Orange CA seeking a senior customer service representative performing as a point of contact for questions and/or complaints related to plan services.
Position Summary: The ideal candidate shall have minimum of two years of customer/member service experience with at least 1 year of call center capacity.
Work Duration: Up to 6 months
Work hours: Monday Friday morning shift 40 hours / week
Position Responsibilities
- Participates in a mission driven culture of highquality 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 longterm 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 inperson or telephonically.
- Serves as a senior resource for other team members (i.e. solves complex challenges answers uncommon questions and shares complex processes and procedures).
- Supports in the coordination of member s health care and social service needs both within and outside the medical group.
- 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 and external care management departments and other department/government or community agencies.
- 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. Provides additional followup assistance as needed.
- Completes other duties or projects as assigned.
Experience & Education
- High School diploma or equivalent required.
- Typing speed of 35 words per minute (WPM) required.
- 2 years of claims experience required.
- 1 year of call center experience with high call volumes or customer service experience analyzing and solving provider claims problems required.
- 1 year of HMO MediCal/Medicaid and healthcare/managed care experience strongly preferred.
- Bilingual in English and in one of the languages (Arabic Chinese Farsi Korean Spanish or Vietnamese) required.
- An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.
Necessary Attributes:
- 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 problemsolve and possess project management skills
- Work in a fastpaced environment and in an efficient manner.
- Manage multiple projects and identify opportunities for internal and external collaboration.
- Motivate and lead multiprogram 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
- Ability to visually read information from computer screens forms and other printed materials and information.
- Ability to speak (enunciate) clearly in conversation and general communication.
- Hearing ability for verbal communication/conversation/responses via telephone telephone systems and facetoface interactions.
- Manual dexterity for typing writing standing and reaching flexibility body movement for bending crouching walking kneeling and prolonged sitting.
- Lifting and moving objects patients and/or equipment 10 to 25 pounds
Please see HR for information on physical demands and work environment of this job.
Sunshine Enterprise USA is an Equal Opportunity Employer Minorities Females Veterans and Disabled Persons
Proficiency in advanced anesthesia techniques for cardiac surgeries. Strong knowledge of critical care principles and management of cardiac conditions. Excellent communication and interpersonal skills, with the ability to work collaboratively in a fast-paced, high-pressure environment. Detail-oriented with strong organizational skills. Ability to make quick and informed decisions during medical emergencies.
Education
Minimum of 3 years of experience in cardiac anesthesia and ICU care, preferably in a hospital or healthcare setting with a high volume of cardiac surgeries. Demonstrated expertise in managing critically ill cardiac patients in the ICU.
Employment Type
Full Time
