Customer Service Specialist I

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Description:
$3,000 sign-on bonus eligible position!

Resolve complaints and inquires and provide information to members, prospective members, providers, other insurance carriers, agents and brokers, attorneys, employer groups and other member or provider representatives in writing, in person and over the telephone. Issues may be health plan related (e.g. medical coverage, claims, referrals, eligibility) or delivery system issues (e.g., appointment access, medical center service complaints, physician selection, fee quotes, patient billing issues) or governance issues (e.g., voting member information, consumer governance policies).

Essential Responsibilities:

  • Responds to health plan, delivery system, and governance inquiries and complaints in writing and over the telephone.
  • Researches issues. Interact with other departments, physicians or administrators as needed. Resolve or escalate when appropriate.
  • Identify errors and determine what corrective steps need to be taken to resolve.
  • Interpret and apply all benefits according to appropriate contract.
  • Document all interactions in contract tracking system according to regulatory guidelines.



Basic Qualifications:
Experience

  • Minimum one (1) years of customer service experience.
  • Education

  • High School Diploma/GED.
  • License, Certification, Registration

  • N/A


  • Additional Requirements:

  • Communication, customer service, analytical and problem solving skills.
  • Ability to exercise discretion.
  • Computer skills in a Windows environment.


  • Preferred Qualifications:

  • Call center experience in a health care or insurance environment.
  • Associate's degree in a related field.


  • Primary Location: Washington,Spokane,Admin. Center North, Spokane
    Scheduled Weekly Hours: 40
    Shift: Day
    Workdays: Mon, Tue, Wed, Thu, Fri
    Working Hours Start: 08:00 AM
    Working Hours End: 05:00 PM
    Job Schedule: Full-time
    Job Type: Standard
    Employee Status: Regular
    Employee Group/Union Affiliation: NUE-WA-04|NUE|Non Union Employee
    Job Level: Individual Contributor
    Department: Spokane Admin North - HP Func-Claims&Refrls Ctrl Rm - 1130
    Travel: No Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    More Information on Kaiser Permanente
    Kaiser Permanente operates in the Healthtech industry. The company is located in Oakland, CA. Kaiser Permanente was founded in 1945. It has 127523 total employees. It offers perks and benefits such as Flexible Spending Account (FSA), Disability insurance, Dental insurance, Vision insurance, Health insurance and Life insurance. To see all 30 open jobs at Kaiser Permanente, click here.
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