Customer Service Representative I

Job Summary

The Customer Services Representative is responsible for increasing customer satisfaction and retention by providing members, customers, patients and providers with accurate, consistent, timely, and meaningful information.

Essential Responsibilities

• Available to handle member inquiries regarding: Member Core, Member Advance, Medicare, Premium Billing Enterprise, KPC Billing, 1095 Tax Form, SLP.
• Responds professionally to inquiries from internal/external customers.
• Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organizations philosophy of providing extraordinary customer relations and quality service.
• Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
• Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
• Develop a full awareness of the way performance and actions affect members and Member Service.
• Contact Centers (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted).
• Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, and protecting the assets of the organization.
• Documents conversations with members according to procedure.
• Follows established procedures to meet customer/member needs.

Required Qualifications

• Minimum two (2) years of customer service experience or KP member-interacting experience required.
• High School Diploma or General Education Development (GED) required.
• Must pass Classification Assessment.
• Minimum typing speed of 30 WPM (Typing test must be current within one (1) year of the posting period).
• Excellent written and verbal communication skills.
• Demonstrated analytical and problem-solving skills.
• Working knowledge of systems used within the MSCC.
• Ability to read and respond briefly, clearly and effectively.
• Ability to think critically and problem solve.
• Manage own work with minimal direction.
• Must pass knowledge checks while in training.

Preferred Qualifications

• Call center experience preferred.
• Health insurance experience preferred.