Samaritan Health Services

Customer Service Representative I (Call Center)


PayCompetitive
LocationRemote
Employment typeOther

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  • Job Description

      Req#: 2021550

      • Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.

        As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

      • This position is remote in Oregon only.

      • JOB SUMMARY/PURPOSE
        • Responsible for ensuring a high level of customer service and accuracy for plan benefits and accompanying workflow. Evaluates communications from members and providers of Health Plan Operations and processes requests accordingly. Acts as primary contact for plan benefit questions for all lines of business for both internal and external customers. Responsible for oral and written communications to members and providers in response to questions and requests.
      • EXPERIENCE/EDUCATION/QUALIFICATIONS
        • High School Diploma or equivalent required.
        • Two (2) years professional customer service experience required.
        • Experience in a health plan setting preferred.
        • Experience with State and Federal rules and regulations (including Medicare and Medicaid) preferred.
      • KNOWLEDGE/SKILLS/ABILITIES
        • Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
        • Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
      • PHYSICAL DEMANDS
        • Rarely
          (1 - 10% of the time)

          Occasionally
          (11 - 33% of the time)

          Frequently
          (34 - 66% of the time)

          Continually
          (67 – 100% of the time)

          CLIMB - STAIRS

          LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs

          LIFT (Knee to chest: 24"-54") 0 – 20 Lbs

          LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

          CARRY 1-handed, 0 - 20 pounds

          BEND FORWARD at waist

          KNEEL (on knees)

          STAND

          WALK – LEVEL SURFACE

          ROTATE TRUNK Standing

          REACH - Upward

          PUSH (0 - 20 pounds force)

          PULL (0 - 20 pounds force)

          SIT

          CARRY 2-handed, 0 - 20 pounds

          ROTATE TRUNK Sitting

          REACH - Forward

          MANUAL DEXTERITY Hands/wrists

          FINGER DEXTERITY

          PINCH Fingers

          GRASP Hand/Fist

  • About the company

      The Samaritan Health Services is a non-profit, integrated delivery healthcare system consisting of five hospitals in Oregon and is headquartered in Corvallis, Oregon.