Customer Service Rep I

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. They are seeking a Customer Service Rep I to respond to member and provider inquiries regarding benefits, eligibility, and claims status, ensuring accurate and timely resolutions.

Responsibilities:

• Provide first call resolution by responding accurately and courteously to member inquiries regarding benefit interpretation, eligibility, accessing care through plan providers and other related issues under Washington Apple Health, Cascade Select Plans and other products as offered by Community Health Plan of Washington
• Document inquiries, complaints, and other data in computer database in an accurate, clear, and timely manner
• Meet attendance and call quality standards
• Perform all functions of the job with accuracy, attention to detail and within established timeframes
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion

Requirements:

• Are committed to serving the underserved community and treating others with respect, courtesy, and maintaining member confidentiality
• Are knowledgeable of Washington Apple Health state medical insurance
• Are knowledgeable of medical terminology and healthcare
• Desire to be part of a collaborative, ever evolving, dynamic team
• Minimum of one (1) year of customer service and/or call center experience preferably in insurance, managed care, or from a provider setting
• Comfortable working in a 100% remote environment
• Ability to gather and assess information from multiple systems, apply protocols, and determine appropriate actions
• Ability to use MS office products such as Outlook, Word, and Excel
• Excellent verbal and written communication skills, including typing
• Complete and successfully pass a criminal background check
• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency
• Vaccination requirement (CHPW offers a process for medical or religious exemptions)
• Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation