Customer Care Rep-Bi Lingual - On-Call

Company Name:
Kaiser Permanente
Represents two positions The customer care representative provides a high level of direct customer service by assisting members or potential members with inquiries related to health plan enrollment, onboarding, benefits, eligibility, service concerns, billing, and payment This can include researching and analyzing a wide variety of complex issues and providing follow up and resolution. Builds and maintains positive relationships with members. Essential Functions: - Utilizes creativity and ingenuity with a ''can do'' attitude to meet patient and member needs and solve problems. - Answers questions from members regarding plans, products, benefits and enrollment and onboarding processes. - Provides clear and concise instructions to members for accessing KP member/patient website and other on-line tools. - Acts as an application counselor to support customers in applying and enrolling in connect for health Colorado. - Supports members in understanding and completing key onboarding tasks such as physician selection and transfer of medications. - Demonstrate outstanding ability to be flexible and accommodating to varied requests from patients, members, staff, physicians and managers. - Acts as a liaison with member services, patient business services, claims, the consolidated service center, medical office operations and other internal departments in order to provide answers to member questions and concerns. - Maintains documentation of all interactions with members. - Assists patient registration associate (PRA) staff and other medical office staff (at all clinics) with higher level customer service inquiries. - Maintains understanding of all Kaiser Permanente insurance products. - Research, resolve and communicate Health Plan/coverage-related assists for members. - Educate providers, staff and individual members on health plan benefits and services. - Effectively handle and attempt to resolve member issues that are received from numerous sources. Appropriately transfer all applicable cases and accompanying documentation after initial resolution effort. - Appropriately interview member/patient (or authorized representative of patient) in person or via phone regarding benefit, service, and medical care issues, document, and triage all case information to correspondence center. - Meet timeframes for performance while balancing the need to produce high quality work related to complex and sensitive member issues. - Partner with and outreach to internal staff, managers and physicians, to identify opportunities to advocate for the member and resolve issues as quickly as possible. - Negotiate with facility, service area, and regional staff (as necessary) to reach satisfactory service solutions to issues that optimize our member''s experience with the services they receive. - Answer questions and manage members on existing / open cases. - Assist non-English or limited-English speaking customers in the use of interpreter services. - Perform other duties, as required. Qualifications: Basic Qualifications: - Four (4) years of experience in healthcare or customer service setting required. - Minimum of two (2) years of experience at KP interacting directly with members in two or more of the following areas; financial services, billing resolving customer complains, detailed plan information, sales, onboarding, claims, billing, benefit plan information or two (2) years of experience outside KP in a highly service oriented position in healthcare or financial services that includes outstanding customer service skills and the ability to resolve billing, payment and service issues required. - High School diploma or equivalent required. - Bilingual Spanish speaking required. - Applicants will also be asked to demonstrate the following skills during a panel interview using behavioral based questions with a scoring method approved by recruiting : customer service skills demonstrated through prior work experience; critical thinking, decision making and problem solving ability;verbal and interpersonal skills;time management and follow through skills; - Intermediate windows computer proficiency test with a passing score of 70% or better required. - Typing test with a minimum of 35 wpm with a 5% or less error rate required. - Must pass a bilingual proficiency assessment test with a minimum score of 80% prior to the interview. Employees in this role with receive a bilingual wage premium.
JOBCOMPANY: Kaiser Permanente

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