Bilingual Sr. Customer Service Representatives
Kforce Inc.
Job Info
RESPONSIBILITIES:
Kforce healthcare client is seeking several Bilingual Senior Customer Service Representatives.Job Responsibilities:- Address member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care
- Verify member eligibility, claim and authorization status for providers
- Responsible for thorough follow-up and completion of all member and provider inquires or requests
- Responsible for accurate, complete, and correct documentation into all issues, inquires, complaints and grievances
- Functions efficiently and productively in a high-volume call center
- Maintain departmental productivity and quality standards
- Provides follow-up assistance as needed
- Routes escalated calls to the appropriate Member Liaison Specialist, Supervisor or Call Center Manager
- Processes all member transportation request within one business day of receipt and coordinating all aspects of the process with the clinic, provider, and member as appropriate or necessary
- Interact face-to-face with members by assisting with front desk coverage
- Serves as a backup for Customer Service Leads, as needed
- Handle and resolves escalated issues
REQUIREMENTS:
- High School diploma/GED or equivalent required
- 2 years of experience in a customer/member service or call center capacity required
- 2 years of Health Maintenance Organization (HMO), Medi-Cal/Medicaid and health services experience preferred
The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.
We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.
Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless and until paid and may be modified in its discretion consistent with the law.
This job is not eligible for bonuses, incentives or commissions.
Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
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