Customer Service Representative I

About the role

Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage and Commercial Large Group plans. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

Responsibilities

• Ensure a high level of customer service and accuracy for plan benefits and accompanying workflow.
• Evaluate communications from members and providers of Health Plan Operations and process requests accordingly.
• Act as primary contact for plan benefit questions for all lines of business for both internal and external customers.
• Handle oral and written communications to members and providers in response to questions and requests.

Requirements

• High School Diploma or equivalent required.
• Two (2) years professional customer service experience required.
• Experience in a health plan setting preferred.
• Experience with State and Federal rules and regulations (including Medicare and Medicaid) preferred.

Skills

• Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures.
• Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
• Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.

Physical Demands

Rarely (1 - 10% of the time) (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 - 100% of the time)

• CLIMB - STAIRS
• LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
• LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
• LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
• CARRY 1-handed, 0 - 20 pounds
• BEND FORWARD at waist
• KNEEL (on knees)
• STAND
• WALK - LEVEL SURFACE
• ROTATE TRUNK Standing
• REACH - Upward
• PUSH (0 - 20 pounds force)
• PULL (0 - 20 pounds force)
• SIT
• CARRY 2-handed, 0 - 20 pounds
• ROTATE TRUNK Sitting
• REACH - Forward
• MANUAL DEXTERITY Hands/wrists
• FINGER DEXTERITY
• PINCH Fingers
• GRASP Hand/Fist