Customer Services Representative

Do you have a desire to help fellow Oregonians resolve concerns for Medicaid and Oregon Health plan? If you have customer service experience that includes explanation of rules, regulations, and policies, we want you to apply for this position!

This posting will be used to fill four (4) permanent, full-time position. These positions are classified and are represented by a union. 

Work Location: Salem/Marion; hybrid position

What you will do!

MEDICAID: Customer Service Representative (4 positions). These positions sit within the Health Systems Division's, Member Services, Client Enrollment and Client Services Unit which serves as first line Ambassadors to Oregon Medicaid and Medicare Members. This team helps Oregon Medicaid and Medicare Members navigate their services and provide solutions and options to any member concern, in order to promote better health, better care and lower costs to the nearly 1.5 million Oregonians who rely upon the Oregon Health Plan (OHP) / Medicaid for their health care supports and services.

This position answers phone calls for Medicaid participants, and their representatives, provides guidance on how to access the Oregon Health Plan, and seeks to resolve any questions or concerns. The majority of time is spent answering participant calls and conducting the necessary follow-up research and entering accurate narratives in several databases. Specifically, in this role you will:

• Provide an explanation of rules, policies and technical procedures so recipients are able to resolve concerns about their health care, billing issues, and how to work with their Coordinated Care Organization;
• Respond to correspondence by phone and/or email with participants, advocates, providers, coordinated care plans, outreach facilities, medical professionals, residential facilities and agency staff;
• Provide information regarding medical benefits by reviewing systems, assisting participants with general questions and referring callers/case to appropriate resources;
• Respond in a professional manner to callers who are feeling frustrated, confused or concerned, or who are seeking support to lodge complaints or report fraud;
• Verify eligibility/coverage dates, coordinated care and third-party resources.

What's in it for you?
The public health division is a team of passionate individuals working to promote health across the lifespan of individuals, families, and communities. We value and support unique perspectives using a trauma-informed approach and aim to reflect these values in our hiring practices, professional development, and workplace. We are committed to racial equity as a driving factor to improve health outcomes for all communities that experience inequities.

• We offer exceptional medical, vision and dental benefits packages for you and your qualified family members, with very low monthly out-of-pocket costs. Try this free virtual benefits counselor by clicking here: https://www.oregon.gov/oha/pebb/pages/alex.aspx
• Paid Leave Days:
  • 11 paid holidays each year
  • 3 additional paid "Personal Business Days" each year
  • 8 hours of paid sick leave accumulated every month
  • Progressive vacation leave accrual with increases every 5 years
• Pension and retirement programs
• Optional benefits include short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
• Click here to learn more about State of Oregon benefits.

WHAT WE ARE LOOKING FOR:

Minimum Qualifications

Two years of experience in customer service. One year of which must have included explanation of rules, regulations, and policies and responsibility for dealing with unique or unusual situations.

Desired Attributes

• Experience in creating and maintaining a work environment that is respectful and accepting of diversity among team members and the people we serve.
• Preference may be given for Spanish-English and/or other bilingual skills or candidates speaking other of the top languages spoken by Oregon Health Plan members such as Spanish, Russian, Vietnamese, Chinese, Ukrainian, Arabic, Somali.
• Experience in creating and maintaining a work environment that is respectful and accepting of diversity among team members and the people we serve.
• Strong ability to communicate with diverse groups and individuals in areas such as responding to inquiries, narrative reports and instructional materials with limited supervision.
• Excellent communication/listening skills in order to interpret and develop the ideas/needs of participants and visualize the best approach to achieve the desired outcome.
• Demonstrates skills in the following areas: 
  • Excellent customer service and person-centered engagement
  • Ability to be flexible and take direction when work priorities shift
  • Ability to provide timely and accurate information to participants
  • Responsiveness and problem-solving skills
  • Positive team collaboration and contribution
  • Excellent decision-making skills and the ability to prioritize workload
  • Multi-line telephone and quality keyboarding skills is required
  • Attendance:  Regular attendance is required to meet the demands of this job and to provide necessary services

How to apply:

Complete the online application at oregonjobs.org using job number REQ-139551

Application Deadline: 10/16/2023