Research, verify and resolve inquiries related to Oregon Health Plan (OHP) or Medicare eligibility with guidance from Supervisor and Customer Service Operations Specialists
Respond and assist members with Primary Care Provider (PCP) assignments
Collaborate with others within Customer Experience and other CareOregon departments to service member customers and explain OHP or Medicare benefit coverage
Use Call Tracking system to document all communications and activities in relation to members, providers and other customers
Maintain confidentiality for all members
Treat all members with honesty, courtesy, dignity and respect
Identify and report any system or process issues; contribute suggestions for improvement
May assist with outbound calls to Medicaid and Medicare members such as welcome and retention calls

Minimum 1 year experience working in customer service or health care
Work experience in a call center preferred
Ability to learn and apply Oregon Administrative Rules (OARs), Federal laws and other regulatory agencies related to medical health insurance and Medicaid or Medicare
Strong computer skills including Microsoft Outlook, Word and Excel
Ability to navigate between multiple documents and internet browsers
Ability to type minimum 35 words per minute preferred
Strong active-listening skills
Ability to interact professionally, patiently and courteously with members in writing and on calls
Strong written and spoken communication skills
Ability to provide clear and concise information and directions as well as follow instructions
Ability to proactively learn department processes
Ability to commit to continual improvement in quality and productivity
Ability to work effectively with diverse individuals and groups

Medical, dental, vision, life, AD&D, and disability insurance
Health savings account
Flexible spending account(s)
Lifestyle spending account
Employee assistance program
Wellness program
Discounts
Multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings)
Strong retirement plan with employer contributions
PTO and Paid State Sick Time based on hours worked/scheduled hours
Paid holidays, volunteer time, jury duty, bereavement leave

Customer Service Representative

Key skills