11 days old

Customer Service Representative

Kelly Services
Lodi, CA 95241
Kelly Services is actively recruiting for multiple **_Customer Service Representative_** openings for our client, one of California's leading health insurance providers, at its location in Lodi, California. This assignment is paying $17.25 per hour starting in October. This is a five month contract opportunity.

**Job Description:**

+ Resolves incoming calls concerning members eligibility, benefits, provider information, monthly premium billing, clinical and pharmacy needs.

+ Composes routine and non-routine correspondence to answer benefits inquiries in writing.

+ Coordinates membership changes such as member's primary care physician.

+ Performs inventory reduction, routine to mid-level, (i.e. member inquiries, may initiate claim adjustments, responds to emails, etc.)

+ Reviews and analyzes member claims for accuracy as well as member education on how benefits are applied.

+ Participate in quality and efficiency workgroups to continuously improve quality member/customer satisfaction as requested.

+ Proactively analyze available programs, determine program eligibility, and connect member to appropriate BSC vendors.

+ Engage members with their wellness plan options.

+ Enhanced knowledge of medical terminology.

+ Comprehensive resolution of pharmacy calls concerning benefit coverage, co-pays, formulary coverage, vacation overrides, and utilization management requirements.

+ Provide prescription related benefit coverage (e.g. explanation of coverage or benefit summary related): Provide prescription co-pays. Provide prescription formulary coverage information and utilization management requirements using web posted printed formulary. Provide a brief description of coverage denial reason and alternatives as listed in the printed formulary. Perform prescription claim overrides.

+ Provide deductible and max out of pocket information.

+ Provide status of a prior authorization requests.

+ Assist members may when and how to appeal a coverage decision.


+ Healthcare Experience (1+ years)

+ Call Center experience (1-2 years)

+ Strong customer service experience (especially with phone correspondence) and a proven ability to meet performance standards

+ Ability to interpret the various health plans and any documentation associated with them

+ Strong organizational skills

+ Ability to work independently

+ Consistent record of dependability in previous positions

+ Ability to interpret the various health plans and any documentation associated with them

+ Requires high school diploma or GED and/or equivalent and 1-2 years of related experience successfully demonstrating increasingly higher level work


+ MS Office skills

+ Strong organizational skills

+ Excellent written and verbal communication skills

+ Ability to work independently

+ Ability to interpret the various health plans and any documentation associated with them

+ Outspoken, with a can-do attitude and infectious positivity

+ A compassionate individual who can convey empathy

**Hours per week:**

+ 40 hour per week; must be available to work an 8-hour shift between the hours 8am to 8pm, 7 days/week. Candidate will have an 8-hour shift within those timeframes.

+ PAID Training: 6 weeks, absolutely no time off and/or tardies during this period; 8am to 4:30pm, Monday through Friday

+ Pay Rate: $17.25 per hour

**Important information: Please submit your resume to be considered for this position.** **If you have questions about the opening, you may contact the recruiter for this position at**

**Why Kelly** **** **?**

As a worker today, its up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find whats next is what were all about. We know whats going on in the evolving world of workjust ask the 440,000 people we employ each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.

**About Kelly** ****

At Kelly, were always thinking about whats next and advising job seekers on new ways of working to reach their full potential. In fact, were a leading advocate for temporary/non-traditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.

Kelly is an equal opportunity employer committed to employing a diverse workforce and providing accommodations for people with disabilities in all parts of the hiring process as required under its Employment Accommodation Policy. Kelly will work with applicants to meet accommodation needs that are made known to Kelly in advance.
Posted: 2020-09-07 Expires: 2020-10-08

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Customer Service Representative

Kelly Services
Lodi, CA 95241

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