Customer Solution Center Service Liaison

Job Summary

The Customer Solution Center Service Liaison I, will communicate to members in all line of business (LOB) regarding: welcome calls, outbound calls, member -Health Risk Assessment, related programs by LOB. Conduct and document outreach activities (call, web, email) consistently and accurately. The Liaison will proactively identify, document, investigate, and resolve member issues in a timely and appropriate manner. The Liaison will also identify potential areas of membership dissatisfaction and recognize improvement areas. The Liaison is responsible for facilitating member enrollment and outreach efforts, with a focus on:
* Health Risk Assessment- ensure to meet all regulatory requirements for Centers for Medicare and Medicaid Services(CMS), and for SPD population.
* Contacting members to obtain their selection of Primary Care Provider (PCP)/clinic, medical group, (and Plan Partner, where applicable) assignment if information was not provided on choice forms, enrollment applications, data transmissions from applicable sources, etc. as well as the preferred threshold language and/or alternative format for receiving their welcome kits, network-related member notification letters, etc.
* Collaborating with internal and external stakeholders and members to facilitate continuity of care and the related enrollments and assignments
* Processing and screening applications and renewals for Healthy Kids members, notifying applicants of the disposition of their application/renewal, and conducting the appropriate follow-up (including review of vendor outreach efforts)
* Working with various internal, Plan Partner, medical group, etc. staff to address questions regarding member eligibility and demographic information.
* Collaborating with Department of Public Social Services (DPSS), Health Care Options, the Ombudsman, Covered California, PASC, third party liability constituency, etc. staff to address and resolve questions, issues, etc. regarding member demographic information (e.g., CIN, name, address, and other related information) so that it can be appropriately updated and reflected in the system. Liaison also attends and participates in various internal and external meetings in this regard.

Education Required

High School Diploma/or High School Equivalency Certificate

Experience

Required:
At least 0-1 years of customer service experience in a corporate setting.

Preferred:
Managed care or healthcare experience.

Skills

Required:
Strong verbal and written and communication skills.

Strong organizational skills.

Demonstrated experience handling complex customer calls.

Preferred:
Bilingual in one of threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.

Job Type: Temporary

Pay: $24.00 - $26.00 per hour

Experience level:

• 1 year

Weekly day range:

• Monday to Friday

Work setting:

• Remote

Education:

• High school or equivalent (Required)

Experience:

• Customer service: 1 year (Required)
• Healthcare: 1 year (Required)

Language:

• Spanish, Chinese, Armenian, Arabic, Farsi or Korean (Preferred)
• Khmer, Russian, Tagalog or Vietnamese. (Preferred)

Work Location: Remote