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Customer Service Specialist I

Location Spokane, Washington Job Number 985838 Date posted 03/10/2022
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$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:
  • 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 Mgr_Member Services_HMO - 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.