Customer Care Representative

September 6

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Umpqua Health

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Umpqua Health is the parent company of Umpqua Health Alliance, one of 16 Oregon coordinated care organizations serving the Oregon Health Plan$1. .$1

51 - 200

Description

• Assist members via various channels (in-person, phone, written) with inquiries about benefits, eligibility, and claims. • Initiate outbound calls for welcome and retention, providing proactive service. • Research and resolve member issues related to health plan eligibility and benefits with accuracy and empathy. • Work closely with internal teams, providers, and regulatory bodies to ensure seamless service delivery. • Maintain detailed records in our Call Tracking system and uphold confidentiality per HIPAA guidelines. • Propose and implement process enhancements to elevate service quality and efficiency. • Advocate for members by understanding their needs and concerns, and escalating issues appropriately to ensure prompt resolution and member satisfaction. • Guide members through complex healthcare systems, explaining coverage details, and assisting with navigating healthcare resources and options. • Demonstrate cultural sensitivity and understanding in interactions with members from diverse backgrounds, ensuring equitable service delivery and support. • Perform other duties and support deliverables as assigned by the organization to help drive our Vision, fulfill our Mission, and abide by our Organization’s Values.

Requirements

• High school diploma or equivalent required; additional coursework or certifications related to healthcare or customer service preferred. • Demonstrated experience in customer service, preferably within a healthcare or insurance setting, with a strong understanding of customer relationship management. • Excellent communication skills, both verbal and written, along with proficiency in problem-solving and using computer systems for data entry and retrieval. • Empathetic listener with a keen attention to detail, dedicated to delivering exceptional service and fostering positive member experiences. • Ability to adapt quickly to changes in procedures and policies, ensuring effective handling of member inquiries and service requests. • Collaborative attitude with a willingness to work closely with team members, providers, and stakeholders to achieve shared goals and deliver seamless service.

Benefits

• Enjoy competitive pay • Medical/dental/vision insurance • Opportunities for advancement