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Providence Customer Relations Representative Management Services Organization - Mission Hills in Mission Hills, California

Description:

Apply today! Applicants that meet qualifications will receive a text with additional questions from our MODERN HIRE screening and interview system.

Providence is calling a Customer Relations Representative Management Services Organization (Full-Time/Day Shift) to Providence Medical Institute in Mission Hills, CA.

The schedule for this position is Mon-Fri 8:00am – 5:00pm.

Please upload a current resume reflecting all relevant experience.

We are seeking an Customer Relations Representative Management Services Organization who will require in-depth understanding of managed care systems and the ability to translate those concepts to patients and providers. Effective communication skills and the ability to handle difficult callers are as critical as good judgment and decision-making skills. Strong interpersonal relations and team building skills are a requirement for internal and external purposes. Experience in a call center environment is essential. Supporting the values of PH&S-CA and proven ability to use team concepts to enhance shared leadership philosophies are essential for the success of this position. The Customer Relations Representative is responsible for answering incoming calls from patients, providers, health plans, and hospitals and providing accurate information to the caller. This position reports to the Manager, Patient, Provider, Health Plan Relations & Compliance. – Management Services Organization.

Perform job activities in accordance with PH&S-CA Mission and Core Values, maintaining confidentiality while creating and maintaining a work environment that affirms and fosters respect for human diversity.

In this position you will:

  • Take a monthly average of 60 plus calls per day and successfully documents, tracks, and resolves issues with supervision.

  • Utilize the Customer Service Module of the GE/IDX system to record and document all pertinent information.

  • Check status of referrals and triages questionable cases to the Referrals’ Department via the GE/IDX Customer Service Module.

  • Check status for claims and triages questionable cases to the Claims’ Departments via the GE/IDX Customer Service Module.

  • Verify and investigate member benefits and eligibility and triages relevant cases to the Enrollment Department via the GE/IDX Customer Service Module.

  • Troubleshoot patient complaints (i.e., access, service and copay issues, etc.) prior to sending the call to the Manager.

  • Investigate patient’s PMG transfer issues such as verifying last dates of service prior to requesting approval from Manager or Director.

  • Meet operating performance standards established by the MSO.

  • Attend meetings as needed.

  • Adhere to safety policies and standards.

Qualifications:

Required qualifications for this position include:

  • Bachelor's Degree in Health Care Administration, Business Administration or an equivalent area or work experience.

  • 3 years experience in customer relations.

  • Solid experience in answering calls in a call center environment.

  • Possesses clear set of personal, organizational and societal values. Knowledge of and commitment to the application of Catholic/Christian health care ministries, principles and values.

  • Must possess working knowledge of managed care and be able to communicate that knowledge to patients and providers.

  • Strong background in effectively dealing with people, some of whom may be in distress and need immediate attention.

  • Must be proficient in the Customer Service module of the GE/IDX system.

  • Skilled in problem solving and troubleshooting.

  • Ability to work collaboratively with other operational units within Providence Health & Services.

  • Ability to perform at high level in an environment of rapid growth, constant change and sometimes ambiguous circumstances.

Preferred qualifications for this position include:

  • Work history emphasis within an independent physician association, management services organization or physician hospital organization.

About the hospital you will serve.

Providence Health & Services is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.

We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit

https://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Patient Services

Location: California-Mission Hills

Req ID: 296608

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