Customer Service Rep, Health Management

Customer Service San Diego, California Carmel, Indiana


Description

Starting pay at $13.50/hour with the potential to earn up to $14.50/hour plus merit increase within the first year. In addition, potential to earn a bonus after a year based on meeting Key Job Accountabilities.

American Specialty Health, Inc. is seeking a Customer Service Representative to join our Customer Service Health Management team. The primary purpose of this position is to provide customer service to members who are seeking or utilizing Health Management programs. 

You are invited to learn more about American Specialty Health's events on our events page.

Responsibilities

  • Receives and responds to telephone calls from members, and health plans/employer groups. 
  • Demonstrates knowledge and understanding of all ASH products and programs through consistent proficiency in quality, quantity, and responsiveness.
  • Responsive to customer contacts in a professional, accurate, timely and courteous manner.
  • Ascertains the nature of the contact and records information in the appropriate system.
  • Provides accurate answers to member inquires by following standard policies and procedures.
  • Interacts in a positive, respectful manner and establishes and maintains cooperative working relationships with internal and external customers.
  • Utilizes defined criteria to determine member qualification for Health Management programs.
  • Coordinates collection of necessary information, including member co-pays or payments when necessary.
  • Coordinates access to Health Management coaches when clinical advice or information is necessary to support the member.
  • Coordinates appointment scheduling for applicable Health Management programs and initiates appointments on behalf of Health Management coaches.
  • Forwards documentation to Research Team for follow up if inquiry requires additional action.
  • Analyzes information, problems, issues, situations and procedures to develop effective solutions to ensure member satisfaction with the Health Management programs.
  • Researches unique questions using all available resources. Refers difficult issues to Supervisor for appropriate answers.
  • Handles all issues requiring additional action within the necessary timeframes.
  • Manages time to ensure calls are answered within required timeframes and appropriate follow up is conducted in a timely manner.
  • Exercises strict confidentiality in all matters relating to the member experience with Healthyroads.
  • Attends and participates in employee and other meetings to discuss issues and foster teamwork among department personnel.
  • Places outbound outreach calls to members who were referred to the program by Health Advocates, DM, or other identified referral source when requested.

Core Competencies

  • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
  • Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
  • Ability to effectively organize, prioritize, multi-task and manage time.
  • Demonstrated accuracy and productivity in a changing environment with constant interruptions.
  • Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
  • Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time. 

Physical Requirements

Ability to speak, see and hear other personnel and/or objects.  Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard.  Ability to lift up to 10 lbs.

Environmental Conditions

Usual office setting.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law. 

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.

Qualifications

  • High school diploma required.
  • Minimum 1 year Customer Service experience; with at least 6 months Customer Service experience in an inbound Customer Service Call Center servicing members. 
  • Experience in healthcare preferred.
  • Basic experience with MS Office.