Health Care Customer Service Rep - 9 positions available!!!!!!!!!!!!!

Appleone

Los Angeles,CA

2/6/2020

Job Description

Immediate need for (9) Health Care Customer Service Reps needed to work on a 6 month temporary assignment.Answers incoming calls from members, potential members, and advocates. Handles and resolves member issues or assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. and assist members in using the self-service tools where available and verifying member eligibility. Performs the completion of PCP transfers. Process plan partner changes. Process payments for L.A. Care Covered members. Document all calls in the system of record. (50%)?Answers incoming calls from providers regarding general provider inquiries, claim status (pre-payment), general program and administration questions for all lines of business including direct member request for I.D cards and PCP changes, triage of calls to appropriate unit. Handles and resolves provider issues or assists providers in connecting with internal units. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC) and assist providers in using the self-service tools where available and verifying member eligibility. Performs the completion of PCP transfers. Process plan partner changes. Handles complex calls as needed coordinates with Member Relations Unit to assist members with complex issues and coordination of care issues within Plan Partners. Assist with new hire shadowing as needed and based on performance metrics. Processing payments for Covered members. Document all call interactions in system of record. ?Assists with the timely contact of members regarding member outreach and retention programs for all lines of business via direct member communication. For immediate consideration, please send your resume as an MS doc to Vivian in the AppleOne Downtown L.A. office and follow up with a phone call and ask for Vivian. For We are an Equal Employment Opportunity employer committed to excellence, diversity and inclusion.

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