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Customer Care Representative

Job ID: 102309 Date posted: May 13, 2020

  • Sharp HealthPlan
  • Operations
  • Clerical Jobs
  • Day Job
  • Full-Time

Responsibilities

Summary
The Customer Care Representative is responsible for direct and timely communication between Sharp Health Plan and Plan members, potential members, providers, employer groups, brokers, internal departments and external agencies.  Maintains high level of knowledge regarding Plan products, premiums, benefits and procedures.  Uses knowledge and judgment to select appropriate resources for assisting callers.  Provides information on all aspects of Plan products, premiums, benefits, policies and procedures.  Responsible for accurate problem-solving. Researches and resolves concerns.
The Sharp Health Plan Customer Care Department is responsible for high quality customer service to Sharp Health Plan members, providers, employers and brokers.  Services provided are wide-ranging, from answering questions about benefits, to making premium payments, to changing PCPs, to assist with referrals.  Customer Care staff communicate with customers by phone, email, mail and in person, and are expected to have an excellent understanding of all health plan operations, services, and benefits.  The Department includes bilingual (English/Spanish) staff.

If you like the sound of what it means to be a Sharp Health Plan team member, and you meet the qualifications above, please submit your resume along with a brief explanation about why you would be a good fit for this position. We look forward to hearing from you!

Sharp Health Plan is the largest, locally-based commercial health plan in San Diego. We are a not-for-profit organization serving the needs of San Diegans since 1992. As a subsidiary of Sharp HealthCare, San Diego’s largest provider of health care services, we not only serve the people of San Diego, we are the people of San Diego.

Through our unique integration with Sharp HealthCare, we connect our members to an award-winning network of hospitals, medical groups and physicians. We offer health insurance options for individuals, families, groups and businesses that combine affordability, choice, high-quality health care and personal service.

Location
This position is located in Kearny Mesa, San Diego County
 
Hours
8 Hour Day Shift: Weekends as needed.
 
 
Required Skills and Qualifications
  • High school diploma or equivalent
  • Minimum of six months experience as a Customer Call Center Representative
  • Demonstrated knowledge of Plan benefits, policies and procedures
  • Knowledge of current matters relating to health maintenance organizations, performance management, and customer satisfaction assessment and delivery
  • Superior interpersonal skills
  • Ability to effectively participate in the activities of the Customer Care area
  • Mature and sound judgment in the commitment of the plan's mission and operating goals
  • Basic computer and writing skills
Preferred Skills and Qualifications
  • AA in Business Administration or Health Care Administration, including courses of study in accounting, finance, marketing, and health care administration
  • Medical office certification, to include medical terminology
  • Two years customer service or medical office experience
  • Health Plan/Insurance industry experience 
  • Supervisory experience
  • Bilingual (English/Spanish) 

 
Sharp HealthCare is proud to be an Equal Opportunity/Affirmative Action Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, gender identity, sexual orientation, protected veteran status or any other protected class.
 

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“After nearly 10 years of working here, it's still one of the hardest jobs I've ever loved. If you find a niche here, you'll be working with some of the smartest in the industry. This is where they'll respect you for thinking outside the box and kindness matters. They expect consistency and hard work, but pay you well to do it.”

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