Healthcare Customer Service Representative

  • location: Phoenix, AZ
  • type: Contract
  • salary: $18.50 per hour
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job description

Healthcare Customer Service Representative

job summary:
JOB SUMMARY

  • Conducts telephonic outreach to members who are identified as needing preventive services in support of quality initiatives and regulatory/contractual requirements.
  • Provides education to members regarding the care gaps they have.
  • Assists in scheduling doctor appointments via three-way phone calls and assists in scheduling transportation services,if needed.
  • Maintains confidentiality of business and protected health information.
  • Conducts telephonic outreach to members to support Quality Improvement regulatory and contractual requirements.
  • Educates the member and their family about preventive health screenings while identifying barriers to care.
  • Schedules doctor appointments for all household members with care gaps with the Primary Care Physician (PCP) and/or Specialist to access needed preventive care services and close gaps in care via a three-way phone call.
  • Informs providers about the care gap(s) member has and why they are seeing the provider.
  • Arranges transportation for members as needed.
  • Documents all actions taken regarding contact related to member.
  • Interacts with other departments including Customer Service to resolve member issues.
  • Refers to CM/DM as appropriate.
  • Completes special assignments and projects instrumental to the function of the department.
  • Performs other duties as assigned.
Education

  • An Associate's Degree in a related field Preferred
  • A Bachelor's Degree in a related field Preferred
Work Experience

  • 1+ year of experience in member provider and customer service or call center environment Required
  • Other Health coaching experience Preferred
  • Other Experience in managed care Preferred
Skills

  • Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Beginner
  • Demonstrated written communication skills Intermediate
  • Demonstrated interpersonal/verbal communication skills Intermediate
  • Ability to effectively present information and respond to questions from peers and management Intermediate
  • Other Data entry skills Intermediate
  • Other Appreciation of cultural diversity and sensitivity towards targeted populations Intermediate
Technology

Microsoft Word Beginner Required

Microsoft Excel Beginner Required

 
location: Phoenix, Arizona
job type: Contract
work hours: 8 to 5
education: High School
experience: 1 Years
 
responsibilities:
  • Conducts telephonic outreach to members to support Quality Improvement regulatory and contractual requirements.
  • Educates the member and their family about preventive health screenings while identifying barriers to care.
  • Schedules doctor appointments for all household members with care gaps with the Primary Care Physician (PCP) and/or Specialist to access needed preventive care services and close gaps in care via a three-way phone call.
  • Informs providers about the care gap(s) member has and why they are seeing the provider.
  • Arranges transportation for members as needed.
  • Documents all actions taken regarding contact related to member.
  • Interacts with other departments including Customer Service to resolve member issues.
  • Refers to CM/DM as appropriate.
  • Completes special assignments and projects instrumental to the function of the department.
  • Performs other duties as assigned.
 
qualifications:
Additional Position Responsibilities - Optional ---- ---- MINIMUM QUALIFICATIONS

Education ---- State the minimum required for the job ---- Education Level Education Details Required/Preferred

  • A High School or GED Required
  • An Associate's Degree in a related field Preferred
  • A Bachelor's Degree in a related field Preferred
Work Experience ---- State the minimum required for the job ---- Experience Level Experience Details Required/Preferred

  • 1+ year of experience in member provider and customer service or call center environment Required
  • Other Health coaching experience Preferred
  • Other Experience in managed care Preferred
Licenses and Certifications ---- List professional licenses and certifications associated with this job ---- Licenses/Certifications Other Licenses/Certifications Required/Preferred

Skills ---- State the minimum required for the job ---- Skill Sets Other Skills Proficiency

  • Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Beginner
  • Demonstrated written communication skills Intermediate
  • Demonstrated interpersonal/verbal communication skills Intermediate
  • Ability to effectively present information and respond to questions from peers and management Intermediate
  • Other Data entry skills Intermediate
  • Other Appreciation of cultural diversity and sensitivity towards targeted populations Intermediate
 
skills: Other
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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