Customer Service Representative I

Samaritan Health Services; Corvallis (OR); On-site; USD 23,000 - 34,000; Full time

Job summary

Samaritan Health Plans is hiring for a customer service role focused on health plan benefits and related workflows. You will evaluate member and provider communications and process benefit requests, serving as the primary contact for plan questions across all lines of business.

The role requires strong written and verbal communication, the ability to work with various levels of the organization, and adherence to state and federal regulations. Experience in a health plan setting is preferred.

Qualifications

• High School Diploma or equivalent required.
• Two (2) years professional customer service experience required.
• Experience in a health plan setting preferred.
• Experience with State and Federal rules and regulations (including Medicare and Medicaid) preferred.

Responsibilities

• Ensure a high level of customer service and accuracy for plan benefits and accompanying workflow.
• Evaluate communications from members and providers and process requests accordingly.
• Acts as primary contact for plan benefit questions for all lines of business for both internal and external customers.
• Communicate orally and in writing with members and providers in response to questions and requests.

Skills

Customer service

Communication

Education

High School Diploma

Job description

Salary Range Salary Range: $16.84 - $24.73

Responsible for ensuring a high level of customer service and accuracy for plan benefits and accompanying workflow. Evaluates communications from members and providers of Health Plan Operations and processes requests accordingly. Acts as primary contact for plan benefit questions for all lines of business for both internal and external customers. Responsible for oral and written communications to members and providers in response to questions and requests.

DEPARTMENT DESCRIPTION

Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage and Commercial Large Group plans. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

EXPERIENCE/EDUCATION/QUALIFICATIONS

High School Diploma or equivalent required.

Two (2) years professional customer service experience required.

Experience in a health plan setting preferred.

Experience with State and Federal rules and regulations (including Medicare and Medicaid) preferred.

KNOWLEDGE/SKILLS/ABILITIES

Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.

Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.

PHYSICAL DEMANDS

Rarely
(1 - 10% of the time)

Occasionally
(11 - 33% of the time)

Frequently
(34 - 66% of the time)

Continually
(67 - 100% of the time)

CLIMB - STAIRS

LIFT (Floor to Waist: 0\"-36\") 0 - 20 Lbs

LIFT (Knee to chest: 24\"-54\") 0 - 20 Lbs

LIFT (Waist to Eye: up to 54\") 0 - 20 Lbs