Purpose of Position: Handles calls from customers to resolve, educate, follow-up and respond to questions regarding CaliforniaChoice plan administration and procedures.
Answers questions by telephone from employers regarding new hires, billings, rates, supplies, administrative procedures, etc.
Educates, via telephone, employees/dependents regarding PCP's, ID cards, RX problems, administrative procedures, dependent coverage, address changes, etc.
Follows-up on calls from brokers regarding problems that their groups are experiencing with providers.
Responds to calls from providers.
Verifies enrollments and resolves claim issues.
Expedites processing of RX issues for employee members.
Document calls in call tracking system.
Departmental standard requires each Customer Service Representative to provide Service of Unequalled Excellence to all callers. Answer 65 calls per day. Provide clear and explicit documentation while maintaining percentage at a level of 90% or higher daily. Make busy time of 30 minutes or less per day.
On-site regular attendance and punctuality are essential functions of the job.
Performs other tasks or functions as assigned.
Requirements Knowledge, Skills & Abilities:
Computer literate and word processing experience.
Typing speed of at least 50 wpm.
Ability to handle irate customers in a courteous, patient, calm and positive manner while maintaining a high quality and quantity of work.
Experience in handling high call volume. Excellent professional verbal and written communication skills.
Knowledge of and experience in the health care/insurance industry.
At least 2 years of customer service experience required.
High school diploma or equivalent.
Must be able to sit 95% of the time, stand and walk 5% of the time. Close vision required. Must be able to hear phone conversations and verbally communicate to caller. Utilize fingers, hands & arms to feel and manipulate. Working environment is stable and noise level is moderate. Apply On-line Send This Job to a Friend
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