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Representative, Customer Service Ll

Company

Kaiser Permanente
Address , Fulton, Md
Employment type FULL_TIME
Salary $27.72 - $33.02 an hour
Expires 2023-06-25
Posted at 1 year ago
Job Description
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 with an increased level of complexity in 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:

Available to handle member inquiries regarding:
  • Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service.
  • Develop a full awareness of the way performance and actions affect members and Member Service Contact Center's (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted).
  • Medicare (For up to two (2) regions.)
  • Member Adv.: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults.
  • Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
  • Performs other relevant duties as required.
  • Completes required training and understand how to use tools available to recall necessary information.
  • Documents according to procedure.
  • Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks.
  • 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.
  • Ability to understand relevant policies, processes and customers.
  • Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
  • Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service Review
  • Follows established procedures to meet customer/member needs.
  • 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.
  • Assist the department in meeting customer needs and reaching department expectations.
  • Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintains the privacy and confidentiality of information, and protects the assets of the organization.
  • Claims: Claim Inquiry, Claim Referral Inquiry, Complaint, General, Provider Demographic Update. Service Review.
  • Responds professionally to inquiries from internal/external customers.
  • Service Billing: Billing Inquiry, Make Payments, Complaints, Payment Plan, General, Service Review
  • PSNAP - Post Stabilization Notification and Authorization Project
  • KPC Billing, 1095 Tax Form, SLP* (escalations to Tier 3)
  • Concierge

Schedule: M-F 12:45-9:15.

Basic Qualifications:

Experience
  • Minimum two-and-a-half (2 1/2) years of customer service experience to include six (6) months as a Customer Service Representative I within the Member Service Contact Center shared service.

Education
  • High School Diploma or equivalent (GED).

License, Certification, Registration
  • N/A

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

Preferred Qualifications:
  • N/A

PrimaryLocation : Maryland,Fulton,Maple Lawn Call Center
HoursPerWeek : 40
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri
WorkingHoursStart : 12:45 PM
WorkingHoursEnd : 09:15 PM
Job Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : M40|OPEIU|Local 2
Job Level : Individual Contributor
Job Category : Customer Services
Department : CSC Maple Lawn - Contact Center-Maple Lawn - 0315
Travel : No
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.