Client Support Specialist providing direct support to healthcare clients in the financial experience. Leading operational changes, project planning, and ensuring clear communication with stakeholders.
OS
Hybrid Customer Service Representative – Public Service Representative 3
Posted 2 months ago
About the role
- Customer Service Representative assisting Medicaid participants in Oregon with inquiries. Providing guidance on the Oregon Health Plan and resolving issues related to healthcare.
Responsibilities
- Answer phone calls from Medicaid participants and their representatives.
- Provide guidance on accessing the Oregon Health Plan and seek to resolve questions or concerns.
- Explain rules, policies, and procedures to help members understand their health care and billing issues.
- Provide guidance on how to work with their Coordinated Care Organization or their Open Card providers.
- Respond to phone and email inquiries from participants, advocates, providers, coordinated care plans, medical professionals, and agency staff.
- Review systems and assist with questions about medical benefits, referring callers to appropriate resources.
- Respond professionally to callers who may be frustrated, confused, or concerned, and support those lodging complaints or reporting fraud.
- Accurately document calls and conduct follow-up research using multiple databases.
- Verify eligibility/coverage dates, coordinated care and third-party resources.
Requirements
- Two years of experience in customer service.
- One year of which must have included explanation of rules, regulations, and policies and responsibility for dealing with unique or unusual situations.
Benefits
- Excellent medical, vision, and dental benefits package for the employee and qualified family members with a very low monthly out-of-pocket cost.
- Optional life insurance, short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
- Employee benefits include 11 paid holidays, 3 personal business days, 8 hours of monthly sick leave, and vacation accrual starting at 8 hours per month.
- Possible eligibility for the Public Service Loan Forgiveness Program.
- Membership in the Public Employees Retirement System (PERS)/Oregon Public Service Retirement Plan (OPSRP).
- Training opportunities that will help grow your career with the State of Oregon.
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