Customer Service Representative I - Bilingual (24771)

CareOregon-posted 11 months ago
$37,610 - $45,970/Yr
Entry Level
Portland, OR
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The Customer Service Representative I is the initial point of contact for members of CareOregon and provides excellent customer service delivery relating to the Oregon Health Plan, Medicaid or Medicare, Group and Individual Medical, Dental and Mental Health. This entry level position typically focuses on member inquiries, but may assist with outbound calls.

  • Research, verify and resolve inquiries relating to Oregon Health Plan or Medicare eligibility with guidance from supervisory and leads.
  • Respond and assist members with Primary Care Provider (PCP) assignments.
  • Learn to collaborate with others inside and outside department to explain benefits not covered by Oregon Health Plan or Medicare and provide information on community resources when appropriate.
  • Work collaboratively with providers, DMAP, or members to ensure effective customer service and the resolution of health plan problems (i.e., eligibility and system) as needed.
  • Use online Call Tracking system to document all activities from any mode of communication from members, providers and other customers.
  • Maintain confidentiality for all members.
  • Coordinate mailing of member materials as needed.
  • Treat all members with honesty, courtesy, dignity and respect.
  • Provide members with professional, timely and competent service.
  • Provide proactive, value added service by identifying and reporting system/technology issues.
  • Consistently meet or exceed Department and Company standards and expectations including but not limited to quality, production and attendance.
  • May assist with outbound calls to Medicaid or Medicare members, which may include welcome and retention calls.
  • Propose and implement process improvements.
  • Meet deadlines for completion of workload.
  • Maintain agreed upon work schedule.
  • Demonstrate cooperation and teamwork.
  • Provide cross-training on specific job responsibilities.
  • Meet identified business goals that contribute to departmental goals.
  • Perform other duties as needed.
  • Minimum 1 year experience required in customer service or health care.
  • Fluency through language testing in a second language relevant to the population served.
  • Ability to learn and apply Oregon Administrative Rules (OARs), Federal laws and other regulatory agencies that relate to the medical health insurance industry and the Medicaid or Medicare industry.
  • Strong computer application skills including MS Windows, Word, Excel and Outlook; comfort navigating through multiple documents and internet browsers.
  • Ability to type minimum 35 words per minute.
  • Work experience in a call center.
  • Estimated hiring range $37,610 - $45,970 / year.
  • 3% Bilingual Differential.
  • 5% bonus target.
  • Full benefits.
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