Providence St. Joseph Health

Job Information

St. Joseph Health / Covenant Health Call Center Representative - HSS Call Center SJHH in Brea, California

We are looking for a Call Center Representative for the HSS Call Center SJHH Department at St. Joseph Heritage Healthcare.

Location: Brea, CA

Work Schedule: Full time - 80 Biweekly hours

Shift: 8 hour, Days

Job Summary:

Under the direction of the Supervisor, Call Center, the Call Center Rep supports the Call Center Team and internal departments by advocating on behalf of members, and helps them navigate through the managed care system. This position is responsible for the resolution of customer inquiries through multiple channels; data entry to maintain computer systems; upkeep of resources to remain current; and coordination of special projects and events.

Essential Functions:

  • Handles intake of multiple phone lines using established scripts, protocols and service processes. Responds to each call in an efficient, effective, and professional manner.

  • Accurately tracks and enters calls using appropriate documentation, reporting, and database applications. Assists with maintaining department databases and resource tools.

  • Notifies members of urgent approvals and denials within appropriate time frames, per guidelines set. Coordinates communication and patient services with Utilization Management Team.

  • Functions as a liaison between internal departments and members regarding referral status, authorizations, eligibility, patient portal registration, physician information, and complaint resolution. Troubleshoots operational and technical issues.

  • Interacts with multiple departments, e.g., Resource Management, I.S., Provider Relations, Utilization Management, Claims, and Eligibility to provide resolution to patient and health plan/vendor inquiries. Supports positive internal relations and communication across all areas.

  • Understands and uses proper procedures to resolve problems, escalate issues, and achieve objectives in a productive and cooperative manner. Provides timely feedback about processes to improve caller experiences and satisfaction.

  • Supports overall department operations through cooperation and teamwork.

Skills :

  • Able to navigate through PC applications. Basic MS Windows, Excel, Word, and Outlook knowledge.

  • Excellent verbal, written, and interpersonal communication skills to communicate effectively with individuals at all levels of the organization.

  • Ability to provide stellar service using excellent advocacy skills and telephone etiquette to build loyalty, extend customer retention, and satisfy corporate goals and objectives.

  • Approaches each customer interaction with professionalism, compassion and empathy.

  • Ability to work in a fast-paced department and maintain a high level of productivity.

  • Successfully handles a high call volume with frequent interruptions.

  • Possess critical-thinking and problem-resolution skills.

  • Excellent follow through skills, responding timely to phone calls, tasks, and projects; accuracy and attention to detail are a must.

  • Possess excellent organizational and time management skills.

  • Ability to prioritize and handle multiple tasks effectively, remain flexible, and adapt to shifting work demands.

  • Must be able to work under general supervision.

  • Able to work independently, but also as a team player. Supports and promotes intra- and inter-departmental teamwork, exhibiting a spirit of cooperation.

  • Present a professional and mature demeanor.

  • Display patience and demonstrates respect for callers and staff. Recognizes diversity of customers and is accepting of individual differences, beliefs and values.

  • Preferred: Medical terminology knowledge.

  • Preferred: Bilingual English/Spanish communication.

Minimum Position Qualifications:

Experience:

  • 2 years of Customer service environment.

  • Basic MS Windows, Excel, Word, and Outlook experience.

Preferred Position Qualifications:

Experience :

  • Experience in a Healthcare setting.

  • Customer service experience in a managed care environment.

  • IDX experience.

Mission Heritage Medical Group is one of California's most respected medical groups. With over 3,000 employees and 75 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, Mission Heritage Medical Group has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values. Mission Heritage Medical Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Mission Heritage Medical Group complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Company: Heritage Healthcare

Category: Administrative (Clinical)

Req ID: R334440

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