Description:
- Client is seeking a highly motivated an experienced TEMP - Customer Service Representative (Non-Bilingual) to join our team. The Customer Service Representative (CSR) will be the first line of contact for Client members and providers. The incumbent will assist members and providers with questions and/or complaints related to the Medi-Cal programs for Orange County. The incumbent will provide information regarding eligibility, enrollment, benefits and services to Client eligible members and providers.
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.
Knowledge & Abilities:
- Develop rapport and establish and maintain effective working relationships with Client 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.
Physical Requirements (With or Without Accommodations):
- 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 face-to-face 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
Work Environment:
- If located at the 500, 505 Building or a remote work location:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
- There are no harmful environmental conditions present for this job.
- The noise level in this work environment is usually moderate.
If located at PACE:
- Work is typically indoors in a clinical setting serving the frail and elderly.
- There may be harmful or hazardous environmental conditions present for this job.
- The noise level in this work environment is usually moderate to loud.
If located in the Community:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
- Employee will occasionally work outdoors in varied temperatures.
- There may be harmful or hazardous environmental conditions present for this job.
- The noise level in this work environment is usually moderate to loud