Customer Service Representative (Call Center)

Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or WisconsinThis position requires staff to work pacific time zone hours.JOB SUMMARY/PURPOSEResponsible for ensuring a high level of customer service and accuracy for plan benefits and accompanying workflow. Evaluates communications from members and providers of Health Plan Operations and processes requests accordingly. Acts as primary contact for plan benefit questions for all lines of business for both internal and external customers. Responsible for oral and written communications to members and providers in response to questions and requests.EXPERIENCE/EDUCATION/QUALIFICATIONSHigh School Diploma or equivalent required.Two (2) years professional customer service experience required.Experience in a health plan setting preferred.Experience with State and Federal rules and regulations (including Medicare and Medicaid) preferred.KNOWLEDGE/SKILLS/ABILITIESEffective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.PHYSICAL DEMANDSRarely
(1 - 10% of the time)Occasionally
(11 - 33% of the time)Frequently
(34 - 66% of the time)Continually
(67 – 100% of the time)CLIMB - STAIRSLIFT (Floor to Waist: 0"-36") 0 - 20 LbsLIFT (Knee to chest: 24"-54") 0 – 20 LbsLIFT (Waist to Eye: up to 54") 0 - 20 LbsCARRY 1-handed, 0 - 20 poundsBEND FORWARD at waistKNEEL (on knees)STANDWALK – LEVEL SURFACEROTATE TRUNK StandingREACH - UpwardPUSH (0 - 20 pounds force)PULL (0 - 20 pounds force)SITCARRY 2-handed, 0 - 20 poundsROTATE TRUNK SittingREACH - ForwardMANUAL DEXTERITY Hands/wristsFINGER DEXTERITYPINCH FingersGRASP Hand/Fist
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