Customer Service Rep I

Community Health Plan of Washington; Seattle (WA); Remote; USD 24,000 - 34,000; Full time

Benefits offered by this job

Medical, Prescription, Dental, Vision

Telehealth app

401(k) employer match

Paid time off & holidays

Employee Assistance Program

Job summary

Community Health Plan of Washington is seeking a fully remote Customer Service Representative to assist members and providers with benefits, eligibility, and claims questions from Washington state. You will work with a collaborative team and must have at least 1 year of call center experience in insurance or healthcare, maintaining confidentiality and accuracy while navigating multiple systems.

MS Office skills and strong verbal/written communication are essential.

Qualifications

• Minimum of one (1) year of customer service and/or call center experience, preferably in insurance, managed care, or from a provider setting.
• Knowledge of Washington Apple Health state medical insurance.
• Knowledge of medical terminology and healthcare.

Responsibilities

• Provide first-call resolution by responding accurately and courteously to member inquiries regarding benefits, eligibility, and access to care.
• Document inquiries and data in the computer system accurately and timely.
• Meet attendance and call quality standards.
• Perform all functions with accuracy and within established timeframes.

Skills

Customer service

Call center

MS Office

Verbal and written communication

Tools

MS Office

Job description

Remote Washington State
Seattle, WA 98101, USA

Description

*This is a fully remote position in Washington.

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

• Strive to a pply an equity lens to all our work.
• Create an equitable work environment.

About the Role

This position is part of a team of representatives who respond to member and provider inquiries regarding benefits, eligibility, status of claims, and other related issues to provide information and facilitate and/or coordinate appropriate resolutions.

To be successful in this role, you:

• Are committed to serving the underserved community and treating others with respect, courtesy, and maintaining member confidentiality.
• Are knowledgeable of Washington Apple Health state medical insurance.
• Are knowledgeable of medical terminology and healthcare.
• Desire to be part of a collaborative, ever evolving, dynamic team.
• Minimum of one (1) year of customer service and/or call center experience preferably in insurance, managed care, or from a provider setting.
• Comfortable working in a 100% remote environment.

Essential functions and Roles and Responsibilities:

• Provide first call resolution by responding accurately and courteously to member inquiries regarding benefit interpretation, eligibility, accessing care through plan providers and other related issues under Washington Apple Health, Cascade Select Plans and other products as offered by Community Health Plan of Washington.
• Document inquiries, complaints, and other data in computer database in an accurate, clear, and timely manner.
• Meet attendance and call quality standards.
• Perform all functions of the job with accuracy, attention to detail and within established timeframes.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion

Knowledge, Skills, and Abilities:

• Ability to gather and assess information from multiple systems, apply protocols, and determine appropriate actions.
• Ability to use MS office products such as Outlook, Word, and Excel.
• Excellent verbal and written communication skills, including typing.

As part of our hiring process, the following criteria must be met:

• Complete and successfully pass a criminal background check.

Criminal History:includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.
• Vaccination requirement (CHPW offers a process for medical or religious exemptions)
• Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits:

The position is FLSA Non-Exempt and is eligible for overtime. The starting salary for this position is $21.00 and has a 5% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate’s job-related knowledge, skills, and experience among other factors.

CHPW offers the following benefits for Full and Part-time employees and their dependents:

• Medical, Prescription, Dental, and Vision
• Telehealth app
• Flexible Spending Accounts, Health Savings Accounts
• Basic Life AD&D, Short and Long-Term Disability
• Voluntary Life, Critical Care, and Long-Term Care Insurance
• 401(k) Retirement and generous employer match
• Employee Assistance Program and Mental Fitness app
• Financial Coaching, Identity Theft Protection
• Time off including PTO accrual starting at 17 days per year
• 10 standard holidays, 2 floating holidays
• Compassion time off, jury duty

Sensory/Physical/Mental Requirements:

Sensory*:

• Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical*:

• Extended periods of sitting, computer use, talking and possibly standing
• Frequent torso/back static position; occasional stooping, bending, and twisting.

Mental:

• Ability to learn and prioritize multiple tasks at a given time and have the capability of handling demanding situations. Analytical/problem solving/critical thinking ability.

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.