• Job Description

  Req#: 1205843
  The Customer Service Representative role at employer offers a rewarding opportunity to enhance customer satisfaction and retention. Join our team to provide accurate, timely, and meaningful information to members, customers, patients, and providers. Build collaborative relationships and promote the use of our services in accordance with compliance guidelines.
  
  Essential Responsibilities:
  - Handle member inquiries regarding various topics, including facility information, web support, ID card inquiries, complaints, and service reviews.
  - Assist with eligibility and benefit inquiries, correspondence, adding/removing dependents, and new member experiences.
  - Provide support for Medicare inquiries in up to two regions.
  - Handle billing inquiries, payment processing, EFT inquiries, reinstatement requests, and service reviews.
  - Address escalations to Tier 3 for KPC Billing, 1095 Tax Form, and SLP.
  
  Responsibilities:
  - Answer and document incoming contacts to determine their nature and respond to complex calls related to specialized product lines.
  - Respond professionally to inquiries from internal and external customers.
  - Initiate contact with relevant personnel to obtain information and resolve concerns or inquiries.
  - Evaluate data and determine appropriate course of action for complaint resolution and service recovery.
  - Follow established procedures to meet customer/member needs.
  - Interact effectively with diverse work units and organizational departments.
  - Understand and apply relevant policies, processes, and customer information.
  - Assist in meeting customer needs and department expectations.
  - Complete required training and effectively use available tools for information recall.
  - Develop awareness of how performance impacts members and MSCC's performance guarantees.
  - Promote and provide customer service consistent with the organization's philosophy.
  - Support compliance and the Principles of Responsibility by maintaining privacy, confidentiality, and protecting organizational assets.
  - Perform other relevant duties as required.
  
  Additional Information:
  - All applicants must comply with the Principles of Responsibility (Kaiser Permanente's Code of Conduct).
  - Privacy and confidentiality of information must be maintained at all times.
  - Protection of organizational assets is required.

• About the company

  Providing high-quality, affordable health care services and improving the health of our members and the communities we serve.

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