Medicaid Customer Service Representative

Moda Health is hiring a Medicaid Customer Service Representative to support members of the Oregon Health Plan (OHP). The role answers member questions, provides information about medical and pharmacy benefits, researches and resolves inquiries, and documents calls while following privacy requirements.

Responsibilities:

• Answer a high volume of calls with professionalism, empathy, and a commitment to solving customer concerns
• Provide accurate, timely information about OHP medical and pharmacy benefits
• Research and resolve complex inquiries to ensure customer satisfaction
• Maintain confidentiality and adhere to privacy policies and HIPAA regulations
• Document calls thoroughly and efficiently using the latest software tools
• Collaborate with a supportive team and experienced leadership to ensure the best outcomes
• Continuously adapt to evolving customer needs in a dynamic work environment

Requirements:

• At least 1 year of experience in a medical insurance or healthcare-related field
• Minimum 1 year of call center or customer service experience
• High School Diploma or equivalent
• Strong computer skills, including typing, 10-key, and Microsoft Office proficiency
• Ability to consistently meet Moda's attendance and punctuality standards as part of job performance expectations
• High speed internet (cable or fiber)
• Experience with medical health insurance or government healthcare programs
• Knowledge of medical terminology
• Medical billing and coding experience
• Experience with trauma informed care model