Customer Service Representative

About the role

The Customer Service Representative position is located in Modesto and is a full-time, fully onsite role.

Responsibilities

• Respond to and resolve a variety of inquiries, requests and issues from external and internal customers in a call center environment.
• Provide information on benefits, eligibility, claims, authorizations and other related items over the phone and in person.
• Research and resolve issues related to claims and authorizations; monitor progress.
• Research and resolve complex eligibility issues; monitor progress.
• Create required documentation, including but not limited to call logs and other tracking systems.

Requirements

• High school diploma or equivalent.
• Customer Service experience.
• At least one year handling heavy call volume (50-100 calls per day).
• Basic conflict resolution skills.
• Ability to type 40 WPM.
• Pass Call Center Listening Skill test with a score of 71+.
• Knowledge of Medi-Cal programs, Medicare DSNP programs, managed care, medical policy benefits and exclusions, medical terminology, ICD and CPT coding.

Qualifications

• Knowledge, Skills, Abilities and Competencies Required.
• Interpersonal skills.
• Strong oral and written communication skills.
• Strong listening skills.
• Basic arithmetic skills.
• Basic knowledge of contact center systems.
• Basic skills in Windows, Word, Excel and Outlook.
• Ability to navigate multiple systems and resources simultaneously.
• Ability to handle confidential information with appropriate discretion.
• Ability to speak and be understood in English.
• Proficiency in one of HPSJ's threshold languages (may be required).

Skills

• Knowledge of Medi-Cal programs.
• Knowledge of Medicare DSNP programs.
• Knowledge of managed care.
• Knowledge of medical policy benefits and exclusions.
• Knowledge of medical terminology.
• Knowledge of ICD and CPT coding.

Benefits

• Competitive salary.
• Robust and affordable health/dental/vision with choices in providers.
• Royalty-free access to a wide range of discounts and savings.
• Generous paid time off (accrue up to 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays).
• CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan.
• Two flexible spending accounts (FSAs).
• Employer-Paid Term Life and AD&D Insurance.
• Employer-Paid Disability Insurance.
• Employer-Paid Life Assistance Program.
• Health Advocacy Supplemental medical, legal, identity theft protection.
• Access to exclusive discount mall.
• Education and training reimbursement in addition to employer-paid elective learning courses.

Pay

Commensurate with experience.

Schedule

Monday to Friday from 8:00 to 4:30 After Training: Monday to Friday from 8:00 to 5:00