Healthcare Customer Service Representative - Community Health Worker

We are currently hiring a Healthcare Customer Service Representative
! If you are a great communicator, compassionate, enjoy a fast-paced work environment, and value being part of a team that makes a difference, you may be the right person for the position! Apply today! Classification: NON-EXEMPT | Status &

Schedule:

FULL-TIME, MONDAY - FRIDAY, 8AM - 5PM.

Location:

ONSITE, this position reports to the Coos Bay Office location. Salary: $18.54 - 25.75$/HOURLY. Department: MEMBER SERVICES |

Reports to:

CUSTOMER SERVICE MANAGER | Supervision Exercised: NON-SUPERVISORY.

Responsible for maintaining a customer-oriented approach while ensuring that designated health plan members receive information and direction for covered OHP benefits including medical, behavioral, dental, non-emergent transportation and substance use care and support necessary to meet their needs. This position provides support to health plan members and providers; serves as a resource for staff and community medical personnel and responds to requests for coordinated care information.

• Minimum High School Diploma or GED;
  Associate degree in business administration preferred
• Minimum two years’ experience in a medical office, clinic or healthcare administration setting and two years’ experience in customer service-related position
• THW Certification preferred, or willing to obtain - Must reside in Oregon
• Bilingual preferred, qualified, certified, or willing to obtain

• Talk with members and providers by phone or in person, handling inquires in a prompt, courteous manner
• Greet persons entering the building in a professional manner, determine nature and purpose of visit, and direct or call appropriate staff member to escort them to specific destinations
• Provide information to guests, members and the public, answer questions with discretion and tact
• Facilitate the resolution of complaints from customers, members, and/or the public, elevate to appropriate staff member(s) as necessary
• Act as a member advocate and liaison with providers and partners as needed to ensure members are connected to services
• Receive inquiries and route any issues to the appropriate person or department for resolution, responding in a timely manner and documenting the action taken
• Understand plan eligibility, benefit package and claims payment requirements
• Research, verify and resolve inquiries relating to Oregon Health Plan and Advanced Health eligibility
• Outreach members by phone to complete Health Risk Assessments
• Complete tracking and status reports
• Use current technology and software to document all activities from any mode of communication from members, providers and other customers
• Assist with the preparation and mailing of letters, notices, member handbooks, flyers, etc. as directed
• Receive and send packages
• Compose, type and edit correspondence, reports, memoranda and other material as assigned
• Ensure that the lobby is clean and kept free from clutter; report if windows, floors, walls, furniture, etc. need cleaning or repair
• Assist with other related clerical and administrative duties as assigned
• Participate in quality and organizational process improvement activities and teams when requested
• Ensure compliance with company policies and procedures as applicable to area(s) of responsibility
• Handle confidential information and materials appropriately and maintain a secure work area
• Other duties as assigned

• Participate in quality and organizational process improvement activities when requested
• Support and contribute to effective safety, quality, and risk management efforts by adhering to established policies and procedures, maintaining a safe environment, promoting accident prevention, and identifying and reporting potential liabilities
• Openly, clearly, and respectfully share and receive information, opinions, concerns, and feedback in a supportive manner
• Work collaboratively by mentoring new and existing co-workers, building bridges, and creating rapport with team members across the organization
• Provide excellent customer service to all internal and external customers, which includes team members, members, students, visitors, and vendors, by consistently exceeding the customer's expectations
• Recognize new developments and remain current in care management and coordination best practice standards and anticipate organizational…