Health Plan of San Joaquin Hiring for Customer Service Representative Job at Modesto, CA Full Time

Do you want to work with an expanding team while giving back to the community? We are seeking a Customer Service Representative with strong communication skills and a passion for providing quality healthcare to our members.

What You Will Be Doing:
This role involves being responsible for responding to and resolving a variety of inquiries, requests and issues from external and internal customers in a call center environment.

• Provides information on benefits, eligibility, claims, authorizations, and other related items over the phone and in person.
• Researches and resolves issues related to claims and authorizations, monitors progress.
• Researches and resolves complex eligibility issues, and monitors progress.
• Creates required documentation, including but not limited to call logs and other tracking systems.

Required Skills*
What You Bring: *
Knowledge, Skills, Abilities and Competencies
Required

• Ability to efficiently and effectively handle calls of heavy volume (50-100 per day), including documentation and resolution.
• Produces work that is accurate and complete.
• Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
• Rebounds from setbacks and adversity when facing difficult situations.
• Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
• Interpersonal skills – interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
• Demonstrates a commitment to HPSJ’s strategy, vision, mission and values.
• Ability to compare and discern the difference between multiple sets of data or information.
• Time management and organizational skills. Uses time effectively and efficiently. Values time.
• Basic skills in Windows, Word, Excel and Outlook.
• Ability to navigate multiple systems and resources simultaneously.
• Ability to type 45 WPM at 90%.
• Ability to handle confidential information with appropriate discretion.
• Ability to speak and be understood in English.

Preferred

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

Required Experience*
What you Have: *
Education and Experience
Required

• High school diploma or general education degree; and
• At least one of year handling heavy call volume (50-100 calls per day).
• At least one of year in a highly customer service facing role (including food service, retail, or similar)

Preferred

• Associate degree
• Experience in customer service in a health plan, managed care and/or Medi-Cal.
• Fluent in HPSJ key threshold languages (such as Spanish)

What You Will Get:

• HPSJ Perks:
• Competitive salary
• Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
• Generous paid time off (starting at 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.

• A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
• A shorter commute – if you’re commuting from the Central Valley to the Bay Area.
• Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.

Our Vision:

• Continuously improve the health of our community.

Our Mission:

• We provide healthcare value and advance wellness through community partnerships.

Job Type: Full-time