Customer Service 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! 

Work Location: Salem/Marion; hybrid position. 

What you will do! 

Customer Service Representative (two positions). These positions sit within the Medicaid 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 1.4 million individuals 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. Consistent and reliable attendance is required to meet the expectations of this job, to facilitate call center volume, and to ensure that OHP member calls are responded to timely. 

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.

OHA values service excellence, leadership, integrity, health equity and partnership and has a strategic goal to end all health inequities by 2030.

What's in it for you?

• We offer exceptional medical, vision and dental benefits packages

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

• 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.
• Demonstrates skills in the following areas:  
  • Constructive and Collaborative Working Relationships 
  • Critical Decision-making and Problem-solving
  • Customer Service and Person-centered Engagement
  • Data Entry Accuracy and Productivity
  • Workload Planning & Prioritization
  • Strong Oral and Written Communication, including preparation of reports. 
  • Multi-line telephone and quality keyboarding skills 
  • Technical and Computer Skills
  • Training and Technical Assistance

Application Deadline:  12/08/2024

Salary Range:  $3,218 - $4,338 Monthly

https://oregon.wd5.myworkdayjobs.com/SOR_External_Career_Site/job/Salem--OHA--Summer-Street/Customer-Services-Representative---two--2--positions--Public-Service-Representative-3-_REQ-170199