Medical Customer Service

  • location: Sacramento, CA
  • type: Temp to Perm
  • salary: $15.50 per hour
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job description

Medical Customer Service

Respond to all member inquiries related to Commercial, Exchange, and/or Individual plans via telephone, email,
or fax.
- Assist members, providers, and brokers with claims-related billing questions and issues as needed.
- Work with department staff to help resolve member issues to ensure resolution within prescribed timeframes.
- Accurately record and refer appeals and grievances according to department protocols and procedures.
- Educate members on the Advantage Referral Program,- the website, and online member
tools available to them.
- Meet department standard of 100% of all calls taken documented into system of record.
- Meet department standards related to performance and attendance.
- Manage difficult or emotional customer situations, responds promptly to customer needs, solicit customer
feedback to improve service, respond to requests for service and assistance, and meet commitments.
- Use tact, discretion and courtesy in dealing with clients, the public, and others encounters in the course of the
work.
- Perform other duties and special projects as assigned.

Responsibilities:
Respond to all member inquiries related to Commercial, Exchange, and/or Individual plans via telephone, email,
or fax.
- Assist members, providers, and brokers with claims-related billing questions and issues as needed.
- Work with department staff to help resolve member issues to ensure resolution within prescribed timeframes.
- Accurately record and refer appeals and grievances according to department protocols and procedures.
- Educate members on the Advantage Referral Program,?? the website, and online member
tools available to them.
- Meet department standard of 100% of all calls taken documented into system of record.
- Meet department standards related to performance and attendance.
- Manage difficult or emotional customer situations, responds promptly to customer needs, solicit customer
feedback to improve service, respond to requests for service and assistance, and meet commitments.
- Use tact, discretion and courtesy in dealing with clients, the public, and others encounters in the course of the
work.
- Perform other duties and special projects as assigned.

Working hours: 6:00 AM - 8:00 PM

Skills:
High School Diploma.
- 1 year experience working in a call center.
- Previous experience working in the health care industry, specifically HMO, is a plus.
- Basic computer skills, including electronic mail, routine database activity, word processing, spreadsheet, graphics,
etc.
- Must be able to speak, read, write, and understand the primary language(s) used in the workplace.

Qualifications:
High School Diploma.
- 1 year experience working in a call center.
- Previous experience working in the health care industry, specifically HMO, is a plus.
- Basic computer skills, including electronic mail, routine database activity, word processing, spreadsheet, graphics,
etc.
- Must be able to speak, read, write, and understand the primary language(s) used in the workplace.

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law. San Francisco Fair Chance Ordinance: Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.

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