CALL CENTER CUSTOMER SERVICE REPRESENTATIVE
About The Position
The Call Center Customer Service Representative (CSR) is responsible for call center-based education, proactive outreach, and enrollment of eligible enrollees into the financial assistance programs. Ensures that enrollees understand the financial assistance programs available i.e., charity care, Medicaid, and health insurance available through the Affordable Care Act (ACA). Utilizes knowledge of the Finance Revenue Cycle Department’s policies, procedures, and guidelines as well as Medicaid/Redetermination Process, and Managed Care to handles patient complaints and propose suitable solutions. Utilizes best practices and performs all duties in accordance with Cook County Health & Hospitals System (CCHHS) and departmental standards, policies, and procedures. This position is exempt from Career Service under the CCH Personnel Rules
Requirements
- High School Diploma or GED is required (Copy of diploma/transcript is due at the time of interview).
- A minimum of Two (2) years of experience associated with screening/processing of individuals seeking Medicaid, SNAP, cash assistance, charity care, or other related social services is required.
- Must be able to travel to work sites throughout Cook County is required
Nice To Haves
- Associate’s degree or equivalent from college or technical school is preferred.
- Three (3) years of experience associated with screening/processing of individuals seeking hospital system or Medicaid managed care plan is preferred.
- Prior experience in Medicaid, managed care, or human services with customer contact by telephone is preferred.
- Call Center experience in a healthcare related organization is preferred.
- Bilingual in one or more of the following: English/Spanish, English/Polish, English/Mandarin or English/Arabic (May be required based on need)
Responsibilities
- Educates Medicaid enrollees of plan options including information on the mandatory managed care choice process
- Assists non-Medicaid individuals with application screening questions and details on how to apply for financial assistance programs
- Answers questions from patients, providers and the public seeking information and assistance with redetermination process and form completion; creates a three-way call with Illinois Medicaid Redetermination Project staff to support the caller’s inquiry
- Provides information and assistance for re-instating or re-applying for coverage to those who have recently lost Medicaid or cash assistance coverage due to failure to complete in a timely manner the redetermination process
- Offers information on other resources or coverage for those who are not eligible for Medicaid or financial assistance programs
- Verifies demographic information of applicants and members for inbound calls for the purpose of updating with the State of Illinois Department of Health Services, Third Party Administrators, and other payors as necessary
- Communicates with quality assurance, patient relations, and patient advocates to support the commitment to quality customer service
- Escalates complex customer inquiries or complaints to the supervisor or manager
- Makes corrections to selected registration errors identified by during the quality review process
- Performs other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
