Customer Service Representative I (Remote In S.cal)

Description:
REMOTE/VIRTUAL WORK ENVIRONMENT FOR CALIFORNIA RESIDENTS (Must be willing to drive to the Member Services Contact Center location in Corona, CA, for equipment pick, technical issue and training and development requirements).
Job Summary:
The Customer Service Representative is responsible for increasing customer satisfaction and retention by providing members, customers, patients and providers with accurate, consistent, timely and meaningful information. They will provide support to members inquiries and issues as they utilize the KP plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.
Essential Responsibilities:

• Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
• Member Adv.: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults.
• Required to effectively interact with diverse work units and relevant organizational departments.
• Member Core: Facility Inquiry, Web Support, Promote KP.Org, Order ID Card, Complaint, ID Card Inquiry, Service Review.
• Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks.
• Available to handle member inquiries regarding:
• Assist the department in meeting customer needs and reaching department expectations.
• Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organizations philosophy of providing extraordinary customer relations and quality service.
• Follows established procedures to meet customer/member needs.
• Develop a full awareness of the way performance and actions affect members and Member Service Contact Centers (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted).
• Completes required training and understand how to use tools available to recall necessary information.
• Medicare: For up to two regions.
• Premium Billing Enterprise: Billing Inquiry, Make Payments, Complaints, EFT Inquiry, General, Reinstatement Request, Service Review, KPC Billing, 1095 Tax Form, SLP* (*escalations to Tier III)
• Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, and protects the assets of the organization.
• Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
• Responds professionally to inquiries from internal/external customers.
• Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues.
• Ability to understand relevant policies, processes and customers.
• Documents according to procedure.
• Performs other relevant duties as required.

Internal Bidding Period: 3/15/2023 to 3/21/2023
Basic Qualifications:
Experience

• Minimum two (2) years of customer service experience required or KP member-interacting experience.

Education

• High School Diploma or equivalent (GED)

License, Certification, Registration

• N/A

Additional Requirements:

• Must pass Classification Assessment
• Ability to think critically and problem solve.
• Minimum typing speed of 30 WPM (Typing test must be current within one (1) year of the posting period).
• Ability to read and respond briefly, clearly and effectively.
• Working knowledge of systems used within the MSCC.
• Excellent written and verbal communication skills
• Must pass knowledge checks while in training.
• Demonstrated analytical and problem-solving skills.

Preferred Qualifications:

• Health Insurance Experience
• Call Center Experience

Notes:

• New hire training may vary in start time, 7a-9a. Set full-time positions will be awarded per the CBA. Shifts may include days, nights, weekends, 24/7.