Customer Service Representative

Are you ready for new challenges and new opportunities?Join our team!AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all.The Opportunity:Position Summary:Provides in/outbound telephonic and occasional face-to-face service to AlohaCare members and providers, using the highest degree of expertise, courtesy, and professionalism with the objective of retaining the customer's business and ensuring their ongoing satisfaction.Primary Duties & Responsibilities:Fields incoming member and provider routine and complex calls concerning benefits, services, claims, and other inquiries.Works in one or multiple queues/skill sets over various client contact channels.Receives and completes member call backs regarding various company surveys, reminders, or mailers.May assist call center leadership in the training and mentoring of newly hired staff.Assists members in Primary Care Physician (PCP) selections and re-assignments in accordance with regulatory agency and AlohaCare policies, and updates member records as needed.Responds to all incoming inquiries relating to member eligibility and assists members in understanding and navigating the enrollment process into the QUEST Integration program.Maintains data integrity by entering and updating information in member and provider database, keeping accurate account of all telephonic transactions.Coordinates routine projects including producing copies, mailings, faxes, and recording all correspondence as indicated.Active team member providing feedback to Call Center management regarding caller inquiry trends, and attentive to changing conditions in the community impacting our customers.Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality.Required Competencies & Qualifications:High School graduate / EquivalentWork experience 1 + years of customer service / customer facing responsibilitiesStrong oral, written and interpersonal communication skills, including telephone etiquetteHigh energy level and ability to perform repetitive tasks in a fast paced work environmentQuick learner with the ability to absorb and retain detailed informationPossess good judgment and common senseWorking knowledge of Microsoft Office (Outlook, Word, Excel and Lync)Flexibility and adaptability to changing prioritiesExcellent attendance, must be punctual and reliableCultural diversity and sensitivityPositive attitude and energyDemonstrates required performance/productivity with routine and complex job duties and call queue management.Preferred Qualifications:Associate degree or post high school graduate training – especially in healthcare, insurance or customer service-related fieldsWork experience 1 + years call center experienceWork experience 1 + years healthcare administration experienceBilingual or Multilingual a plus – particular consideration for Chuukese, Marshallese, Korean, Ilocano or Tagalog speakersPrior experience demonstrates consistently strong quality audit ratingsCall center or customer contact experience working with inbound and outbound customer callsPhysical Demands/Working Conditions:Requires prolonged operation of a computer workstation, including the ability to type for extended periods of time on a keyboard during the scheduled work day.May require occasional lifting, up to 20 pounds.AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws.

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