Customer Service Representative I - Remote (Must Live in CO)

Kaiser Permanente is a healthcare organization providing health plan and medical services to members, customers, patients and providers. The Customer Service Representative I handles member inquiries, documents contacts, resolves complaints, coordinates service recovery, and provides accurate information about health plan and provider services while maintaining compliance and confidentiality.

Responsibilities:

• Member Core: Facility Inquiry, Web Support, Promote KP. Org, Order ID Card, Complaint, ID Card Inquiry, Service Review
• Member Advance: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults
• Medicare (For up to two (2) regions)
• Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service Review
• KPC Billing, 1095 Tax Form, SLP* (escalations to Tier 3)
• 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
• Responds professionally to inquiries from internal/external customers. 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
• Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed
• Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery
• Documents conversations with members according to procedure
• Follows established procedures to meet customer/member needs
• Required to effectively interact with diverse work units and relevant organizational departments
• Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks
• Ability to understand relevant policies, processes and customers
• Assist the department in meeting customer needs and reaching department expectations
• Completes required training and understand how to use tools available to recall necessary information
• 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)
• Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintains the privacy and confidentiality of information, and protects the assets of the organization
• Performs other relevant duties as required

Requirements:

• Minimum two (2) years of customer service experience or KP member-interacting experience required
• High School Diploma or General Education Development (GED) required
• Excellent written and verbal communication skills
• Demonstrated analytical and problem-solving skills
• Working knowledge of systems used within the MSCC
• Ability to read and respond briefly, clearly and effectively
• Ability to think critically and problem solve
• Required Testing: Contact Center Simulation - Must obtain a Recommend rating
• Typing test - 30 wpm with 5% or less error rate
• Writing test - must obtain an overall score of 30
• Math test - must obtain an overall score of 30
• Must successfully pass knowledge checks while in training
• Call center experience preferred
• Health insurance experience preferred