Healthcare Customer Service Representative - Community Health Worker

DOCS Management Services•Coos Bay, OR

21d•$19 - $26•Onsite

About The Position

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 Job Purpose: Customer Service Representative 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.

Requirements

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
Must reside in Oregon
Critical attention to detail for accuracy and timeliness
High degree of initiative, judgment, discretion, and decision-making
Ability to exercise sound clinical judgment, independent analysis, critical thinking skills, and knowledge of health conditions to determine best outcomes for members
Ability to report to work as scheduled, and willingness to work a flexible schedule when needed
Proficient in Microsoft Office Suite and Windows Operating System (OS)
Knowledge and understanding of how the positions’ responsibilities contribute to the department and company goals and mission
Knowledge of federal and state laws including OSHA, HIPAA, Waste Fraud and Abuse
Awareness and understanding of equity, diversity, inclusion, and the equity lens: ability to analyze the unfair benefits and/or burdens within a society or population by understanding the social, political, and environmental contexts of policies, programs, and practices
Excellent people skills and friendly demeanor
Critical thinking skills of using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems
Attention to detail and organization skills
Ability to handle stress and sensitive situations effectively while projecting a professional attitude
Ability to communicate professionally, both conversing and written
Ability to work with diverse populations and interact with people of differing personalities and backgrounds
Sensitive to economic considerations, human needs and aware of how one’s actions may affect others
Ability to organize and work in a sensitive manner with people from other cultures
Poised; maintains composure and sense of purpose

Nice To Haves

THW Certification preferred, or willing to obtain
Bilingual preferred, qualified, certified, or willing to obtain
Training in or awareness of Health Literacy, Poverty Informed, Systemic Oppression, language access and the use of healthcare interpreters, uses of data to drive health equity, Cultural Awareness, Trauma-Informed Care, Adverse Childhood Experiences (ACEs), Culturally and Linguistically Appropriate Service (CLAS) Standards, and universal access

Responsibilities

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, escalate 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 modifications
Advance personal knowledge base by pursuing continuing education to enhance professional competence
Promote individual and organizational integrity by exhibiting ethical behavior to maintain high standards
Represent organization at meetings and conferences as applicable