Description |
As a member of Kaiser Permanente Colorado's team, you'll be proud of the contributions you make every day. From our financial professionals and IT team members to our RNs and physicians on the front line of care-we work together to advocate the health and well-being of our members, colleagues, and communities. And we do it all in an environment known for breathtaking scenery. Maintaining a close relationship with the natural beauty that surrounds them, the cities of Denver, Boulder, Longmont, and Colorado Springs offer something for everyone-from historic districts to family neighborhoods to world-class ski resort trails. Prepare to be inspired.
Increase customer satisfaction and retention by providing members, customers, patients, and providers with accurate, consistent, timely, and meaningful information. Build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.
Essential Functions:
- Be available to handle member inquiries. Represent Health Plan by answering and documenting all incoming contacts to determine their nature, and respond to complex calls related to specialized product lines or ques.
- Respond with empathy to complaints and concerns from members concerning health plan benefits, account status, payment history, and medical services.
- Initiate contact with the appropriate health plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.
- Evaluate data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.
- Document according to procedure. Assist department in reaching call handling goals, first contact resolution goals, complaint resolution compliance, member retention and making return contact as warranted.
- Complete required training (including, but not limited to, annual certifications) and understand how to use tools available to recall necessary information.
- Effectively diffuse anger, tension, and hostility, within regulatory guidelines, of members expressing concerns about KP.
- Maintain awareness of the way performance and actions affect members and KP's financial stewardship.
- Be open and receptive to feedback, and change behavior to improve performance.
- In addition to defined technical requirements, accountable for consistently demonstrating service behaviors & principles defined by the Kaiser Permanente Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives
- Also accountable for consistently demonstrating the knowledge, skills, abilities, & behaviors necessary to provide superior & culturally sensitive service to each other, to our members, & to purchasers, contracted providers & vendors
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Requirements |
Basic Qualifications:
- A minimum of 2 years customer service experience required
- High school diploma or equivalent
- Minimum typing speed = 30 WPM
- Succeed in required skill assessment of Windows operating system, Microsoft Word, & website navigation.
- Succeed in required skill assessment of basic math/accounting.
- Bilingual Spanish speaking required. Must pass a bilingual proficiency assessment test. Employees in this role with receive a bilingual wage premium.
- Has substantial understanding of the job & applies knowledge & skills to complete a wide range of tasks
- Ability to thoroughly understand a large, complex organization & its functional policies, processes, & customers
- Excellent written & verbal skills
- Ability to effectively interact & negotiate w/ diverse work units at all organizational levels
- Demonstrate analytical & problem-solving skills
- Basic knowledge of mainframe & personal computers required
- Succeed in required skill assessment of Windows operating system, Microsoft Word, & website navigation
- Demonstrate strong reading comprehension & writing stills to analyze & document interaction
- Succeed in required skill assessment of basic math/accounting
- Follow established procedures to meet customer/member needs
- Demonstrates primary commitment to customer/member needs (before other requirements), intervening & taking immediate action as appropriate
- Ability to read & respond clearly & succinctly
- Ability to think critically
- Excellent written & verbal skills
- Demonstrate analytical & problem-solving skills
- Ability to understand, interpret, act on, & direct own work based on analysis of a variety of statistical measurements of individual & contact center performance
- Demonstrated customer service skills, customer focus abilities & the ability to understand Kaiser Permanente customer needs
Preferred Qualifications:
- Call center experience preferred
- Health insurance experience preferred
Primary Location: Colorado-Denver
Scheduled Hours (1-40): 40
Shift: Variable
Working Days: Mon - Fri
Working Hours Start: variable
Working Hours End: variable
Schedule: Full-time
Job Type: Standard
Employee Status: Regular
Employee Group: SEIU - Local 105
Job Level: Individual Contributor
Job: Customer Services
Public Department Name: Member Services
Travel: No
Job Eligible for Benefits: Yes
External hires must pass a background check/drug screen. We are proud to be an equal opportunity/affirmative action employer.
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