Customer Service Representative
Regal Medical Group, Inc.
- United States
- United States
À propos
We are looking for a Customer Service Representative to join our Member Services team in West Hills, CA .
Under general supervision, respond to telephone inquiries from members, Health Plans, providers and employer groups to provide information and clarification relating to RMG services such as claims, referrals, and eligibility in resolving inquiries and more:
Essential Duties and Responsibilities include the following:
- Serve as the primary point of contact for members, addressing inquiries related to authorizations, billing, eligibility and general information, and services in both English and Spanish.
- This position is accountable for providing quality customer service handling incoming/ outgoing calls involving issues from members, providers and health plans.
- Maintain or exceed quality and productivity standards of 35 calls per day with clear and concise detailed documentation of 90% incidents
- Research and resolve routine or complex issues relating to services provided by RMG/LMG/ADOC. This includes eligibility, referral status, provider availability, case management, utilization management, billing related issues and general information.
- Ability to work independently in the resolution of member complaints and other service related issues.
- Resolve issues and concerns efficiently by coordinating with relevant departments and maintaining accurate records of member interactions.
- Educate members on their rights and responsibilities, as well as the proper use of health care
- Maintain up-to-date knowledge of HMO policies, procedures, and health care regulations to provide accurate information.
- Facilitate communication between members and healthcare providers to ensure clarity and
- Participate in training sessions and team meetings to enhance service delivery and share best practices.
- Contribute to a positive and supportive team environment.
- Prioritize assignments and other work functions in order to maintain workflow.
- Display professionalism, good judgment, maturity, and fairness when interacting with others.
- Perform copy and fax functions as needed.
- Maintain accurate and good grammatical communication, both verbal and written, with all levels of management, staff, members and providers.
- Follow HIPAA guidelines with all information pertaining to member medical information and privacy
- Display warm and pleasant phone personality, emphasizing tact, empathy and patience.
- Other duties as assigned.
The pay range for this position at commencement of employment is expected to be $21 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary
Compétences linguistiques
- English
Avis aux utilisateurs
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