Customer Service Specialist I

Kaiser Permanente - Renton, WA
Description:
Resolve complaints and inquires and provide education to members, prospective members, providers, other insurance carriers, agents, brokers, attorneys, employer groups and other member or provider representatives in writing, in person and over the telephone. Health plan related issues may include medical coverage, claims, referrals or eligibility. Delivery system issues may include appointment access, medical center service complaints, physician selection, fee quotes and patient billing issues. Governance issues may be voting member information or consumer governance policies.

Essential Responsibilities:

  • Responds to health plan, delivery system, and governance inquiries and complaints in writing and over the telephone.
  • Researches issues.
    Interact with other departments, physicians or administrators as needed. Resolve or escalate when appropriate.
  • Identify errors and determine what corrective steps need to be taken to resolve.
  • Interpret and apply all benefits according to appropriate contract.
  • Document all interactions in contract tracking system according to regulatory guidelines.
  • Basic Qualifications:

    Experience

    • Minimum one (1) years of customer service experience.

    Education

  • High School Diploma/GED
  • License, Certification, Registration

  • N/A
  • Additional Requirements:

  • Analytical, communication and problem solving skills.
  • Computer skills.
  • Ability to exercise discretion.
  • Preferred Qualifications:

  • Two (2) years of call center experience in a health care or insurance environment.
  • Associate's or bachelor's degree.
  • Apply
    Attention - In the recruitment process, legitimate companies never withdraw fees from candidates. If there are companies that attract interview fees, tests, ticket reservations, etc. it is better to avoid it because there are indications of fraud. If you see something suspicious please contact us: [email protected]