Call Center Representative

Orange, CA 92869

Post Date: 04/04/2018 Job ID: 42363 Profession: Medical Customer Service

Immediate Openings for Call Center positions to work with a large healthcare provider in Orange County working in Orange and Yorba Linda.

  • Answers incoming calls and responds to each call in an efficient, effective, and professional manner.
  • Responsible for maintaining knowledge of all providers scheduling attributes, facility locations and facility personnel.
  • Maintain knowledge of and perform efficient scheduling and messaging functions.
  • Responsible for knowledge and verifying eligibility.
  • Research required information using available resources.
  • Identify and escalate priority issues.
  • Follow up on calls where necessary.
  • Provides member eligibility and referral status information to customers adhering to HIPAA guidelines.
  • Accountable for individual performance metrics , schedule adherence and appropriate use of telephone techniques.
  • Takes messages that are thorough, complete and understandable using task templates. Responsible for using available resources to obtain first call resolution, determine appropriate escalation.
  • Interacts with various departments, i.e. Physician offices, Clinical Staff, Provider Relations, Claims, Eligibility, and Contracting if appropriate to resolve issues on half of the member of health plan.
  • Educates members on how to appropriately access medical care and provides assistance to physician offices regarding network policies and procedures. Knowledge of Front Office duties and responsibilities. General clerical; faxing, copying, filing, distribution daily schedules.

Hours are daytime hours, shifts are varied, rates DOE $16.00 - $19.00 per hour

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