Customer Service Representative, CC

Partnership HealthPlan of California; Fairfield (CA); On-site; USD 39,867 - 46,838; Full time

Job summary

Partnership HealthPlan of California is seeking a customer-focused administrator to handle member and provider inquiries related to care coordination. You will answer calls, route to the right teams, and document interactions to ensure seamless referrals and timely resolutions.

Responsibilities include managing the regional helpdesk, coordinating with internal departments, and providing excellent customer service.

Qualifications

• High School Diploma or equivalent; minimum three years administrative experience required.
• Two years of experience working in a health care setting recommended.
• Strong written and oral communication skills; advanced computer skills.

Responsibilities

• Respond to member and provider inquiries via CareCoordination ACD line and route as needed.
• Document calls and process referrals to appropriate programs per department policies.
• Coordinate with internal departments and external organizations to resolve issues.
• Manage the Care Coordination regional helpdesk and route emails or enter referrals.

Skills

Communication skills

Customer service

Multitasking

Interpersonal skills

Bilingual (Spanish/Tagalog/Russian)

Education

High School Diploma

Tools

Microsoft Office Suite

SharePoint

Job description

Overview

To respond to member and provider inquiries regarding case management telephonically. Ensures that callers’ questions and/or problems are resolved or are directed to the appropriate person for resolution and/or entered as a referral for case management while providing the highest level of customer service.

Responsibilities

• Supports the Care Coordination Department by answering the ACD telephone line, determining call urgency and routing calls appropriately.
• Responds to member and provider issues and questions received through the CareCoordination ACD line.
• Provides excellent customer service and communicates with others in accordance with Partnership standards and expectations.
• Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and Partnership employees.
• Responds to inquiries in a timely manner.
• Documents calls as appropriate.
• With direction, initiates and processes referrals to appropriate programs in accordance with department policies, and communicates referral outcomes to referral source.
• Works with internal departments, providers, and external organizations to resolve issues as needed.
• Manages the Care Coordination regional helpdesk and routes emails or enters referrals appropriately.
• Other duties as assigned.

Secondary Duties and Responsibilities

• Provide support and assistance to coordinators and health care guides as needed.

Qualifications

Education and Experience

High School Diploma or equivalent; minimum three years administrative experience required. Two (2) years of experience working in a health care setting recommended.

Special Skills, Licenses and Certifications

Strong written and oral communication skills. Advanced computer skills, including proficiency in multiple software applications including Microsoft Office Suite and SharePoint. Strong organizational and multitasking skills. Excellent interpersonal and customer service skills. Bilingual skills in Spanish, Tagalog, or Russian may be preferred.

Performance Based Competencies

Must be able to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to function effectively with frequent interruptions and direction from multiple team members.

Work Environment And Physical Demands

More than 50% of work time is spent using a desktop computer. When necessary, the ability to lift, carry, or move manuals and reports, weighing up to 25 lbs.

All HealthPlan employees are expected to:

• Provide the highest possible level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices;
• Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

Hiring Range

$28.94 - $34.00

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.