Experienced Customer Service Representative – Healthcare Industry

We are seeking a highly skilled and compassionate Customer Service Representative to join our team at careerzynith, a leading Independent Physician Association in Southern California. As a Customer Service Representative, you will play a vital role in providing exceptional service to our members and health plans, ensuring a smooth and positive experience for all stakeholders. If you have a passion for delivering outstanding customer service, a strong work ethic, and a desire to grow your career in a dynamic and supportive environment, we encourage you to apply.

About careerzynith

careerzynith is one of the fastest-growing Independent Physician Associations in Southern California, serving a diverse population with a focus on delivering high-quality, patient-centered care. Our team is dedicated to providing exceptional service to our members, health plans, and patients, and we are committed to fostering a culture of teamwork, learning, and advancement. As a valued member of our team, you will have opportunities to grow and develop your skills, work with a talented and supportive team, and contribute to the success of our organization.

Key Responsibilities

As a Customer Service Representative, you will be responsible for:

• Responding to telephone inquiries from members and health plans, providing information and clarification on RMG/LMG services, such as authorizations, member billing, referrals, and eligibility
• Maintaining or exceeding quality and productivity standards, including a minimum of 35 calls per day with matching documentation
• Anticipating the needs of members and callers, understanding their wants and needs, and determining the level of intervention required
• Utilizing standardized processes and tools, researching EZCAP 6X and REA/LEA Systems, and resolving routine or complex issues relating to services received within the medical group
• Documenting all interactions in the EZCAP 6X customer service module and REA/LEA
• Providing essential information to members regarding authorizations, billing issues, eligibility, and urgent cares
• Maintaining patient confidentiality, following HIPAA and PHI processes
• Accessing Interpretation language line for non-English patients as needed
• Working independently to resolve telephonic issues and prioritizing work to maintain workflow
• Ensuring accurate and professional communication with all levels of management, staff, and external customers
• Displaying a warm and pleasant phone personality, emphasizing tact, empathy, good judgment, and patience
• Self-starting, willing to take on multiple tasks, and reviewing and interpreting health plan benefits and provider contracts

Essential Qualifications

To be successful in this role, you will need:

• A minimum of two (2) years of customer service or healthcare setting experience
• Multi-line telephone experience
• High School Diploma or equivalent
• Ability to deal responsibly with matters of a confidential nature
• Ability to multi-task and meet deadlines in a high-stress environment
• Excellent communication skills, both verbal and written
• Ability to read, write, and understand the English language
• Pleasant telephone manner and telephone etiquette
• Ability to distinguish the differences between CPT, HCPCS
• Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access, and PowerPoint)
• Knowledge of computers, faxes, printers, and all other office equipment
• Self-starter, willing to take on multiple tasks
• Ability to review and interpret health plan benefits and provider contracts
• Able to interface with customers both internal and external of careerzynith

Preferred Qualifications

While not required, the following qualifications are highly desirable:

• Experience working in a healthcare setting, particularly in customer service or medical billing
• Knowledge of health plan benefits and provider contracts
• Proficiency in EZCAP 6X and REA/LEA Systems
• Experience working with diverse populations and cultures
• Bilingual or multilingual skills

Work Environment and Culture

careerzynith is committed to providing a supportive and inclusive work environment that fosters growth, learning, and advancement. Our team is dedicated to delivering exceptional service to our members, health plans, and patients, and we are passionate about making a positive impact in our community. As a valued member of our team, you will have opportunities to:

• Work with a talented and supportive team
• Contribute to the success of our organization
• Grow and develop your skills through training and professional development opportunities
• Participate in company celebrations and events
• Enjoy a business-casual working environment
• Take advantage of our comprehensive benefits package, including medical, dental, and vision insurance, 401(k) eligibility, and paid time off

Compensation and Benefits

careerzynith offers a competitive compensation package, including:

• A base salary of $20-$21 per hour, depending on experience and qualifications
• A comprehensive benefits package, including medical, dental, and vision insurance, 401(k) eligibility, and paid time off
• Opportunities for professional development and growth
• A supportive and inclusive work environment
• A business-casual working environment

How to Apply

If you are a motivated and compassionate individual with a passion for delivering exceptional customer service, we encourage you to apply. Please submit your application today, and join our team at careerzynith. Apply for this job