Customer Service Representative
Company: San Francisco Health Plan
Location: San Francisco
Posted on: August 17, 2019
Overview POSITION SUMMARY As a Customer Service Representative,
you'll have one of the most important roles in our organization as
the face of our Health Plan. If you enjoy working in an exciting,
talented & fun team environment where you'll learn a wealth of
knowledge and grow your client relation skills, this is your
opportunity. You will naturally thrive on listening, talking with
and helping others, be outgoing and committed to improving every
member's call experience and help address any questions and/or
issues professionally and efficiently. You are responsible for
serving SFHP clients, among them our Health Plan members,
prospective members, providers, staff members and the public in
general. You will help to provide Health Plan orientation,
education, and assistance, including plan benefits, updates,
programs, policies, complaints and procedures. Being well spoken,
clear and patient with all interactions should accurately describe
you. WHAT YOU'LL DO
- Responds to customer requests, questions, concerns, and
complaints in a timely, respectful, caring and competent
- Answers telephone calls promptly and minimizes delays that may
lead to abandoned calls.
- Verifies member eligibility, coverage or exclusion of
- Assists members in selecting or changing personal doctors or
medical groups according to established guidelines.
- Informs and educates customers on Plan policies, procedures and
- Promotes the rights and responsibilities of Plan members.
- Provides information, referrals and coordinates member services
with community resources for covered and non-covered services.
- Participates in activities that reach out to prospective
members and to the communities that the Plan serves.
- Keeps the Customer Service Supervisor and Manager informed of
service problems, changes in our contact database, including
members, providers, resources, etc.
- Receives customer complaints and works with the Customer
Service Supervisor and/or Manager to resolve concerns.
- Provides information to members on preventive and primary care
- Compiles and enters electronic data.
- Completes all training programs and certifications as
- Assists prospective members with applications for Medi-Cal,
Healthy Families, Healthy Workers and other lines of business as
needed and according to guidelines.
- Provides coverage of all areas under the responsibility of
Customer Service, including front desk and mail services. WHAT
- 1-2 years of experience in customer service, call center, or
- Excellent written/oral communication skills with a high degree
of professionalism, including discretion in working with
- Good knowledge of MS Office and customer management
- Ability to produce accurate, precise and quality work in a
dynamic and diverse environment while meeting deadlines.
- Able to work well both as a team and independently.
- Familiarity with health care and managed care terminology
- Prior experience in health care and knowledge of managed care
or Medi-Cal preferred.
- College degree is preferred or equivalent work experience. San
Francisco Health Plan (SFHP) is a an award winning, managed care
health plan whose mission is to provide affordable health care
coverage to the underserved low and moderate-income residents in
San Francisco county. San Francisco Health Plan is chosen by eight
out of every ten San Francisco Medi-Cal managed care enrollees and
its 145,000+ members have access to a full spectrum of medical
services including preventive care, specialty care,
hospitalization, prescription drugs, and family planning services.
SFHP was designed by and for the residents it serves, and takes
great pride in its ability to accommodate a diverse population that
includes young adults, seniors, and people with disabilities. San
Francisco Health Plan is an Equal Opportunity Employer (EOE)
M/F/D/V Pursuant to the San Francisco Fair Chance Ordinance, we
will consider for employment qualified applicants with arrest and
Keywords: San Francisco Health Plan, San Francisco , Customer Service Representative, Sales , San Francisco, California
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