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Customer Serv Rep - CHOC MSO

San Diego, California
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Job ID 15477 Date posted 11/03/2024 Schedule Full-Time Shift Day Department Admin Services

Would you like a job that has purpose? Are you passionate about caring for children and their families? Consider joining the Rady Children's Customer Service Team!

This position is full time with benefits and generous paid time off. It will be 100% in the office until fully trained, after which time, a hybrid option may be offered. Optional overtime is offered if you would like even more hours.

This is an incredible team to work with. We love serving our members and find purpose in supporting them. The insurance process can be frustrating and we are here to help.

The Customer Service Representative’s primary role is to support relationships with members, providers and health plans. We provide timely, courteous resolution of issues and friendly answers to questions. Responsibilities include:

Answering calls from provider offices and members of the medical group

Performing PCP assignment updates

Providing or scheduling translation services

Data entry of authorization requests

Authorization processing

Researching and responding to provider calls regarding authorization or claim payment status

Any other questions they may have

Skills required:

Knowledge of medical terminology, ICD-10 codes, CPT Codes, HCPC Codes, Health Plan benefits, or claims

Positive, friendly demeanor

Superb listening skills with natural curiosity

Strong time management and multi-tasking ability with attention to details

Outstanding communication skills, both verbally and in writing

Patience, compassion, and empathy

Masterful problem-solver

Motivation to meet (or exceed) service goals

Our efforts allow members to access much-needed medical care. The opportunity to learn and grow within the medical insurance industry can become a career with limitless possibilities.

We would love you to join our team! Please review the requirements below and apply if qualified.

Minimum qualifications:

High School graduate, GED, or Equivalent

1 year of experience (Bachelor's degree considered in lieu of experience)

Excellent communication and interpersonal skills

Knowledge of medical terminology, ICD-10 codes, CPT Codes, HCPC Codes, Health Plan benefits, or claims

Previous experience in the health care field, such as hospital, medical group, health insurance, or other Risk Bearing Organization (RBO)

Preferred qualifications:

Bachelor's Degree

Computer skills, including Excel, EZ Cap, Word, Outlook, and data entry systems

The expected hiring range for this position is $21.00 to $28.88

Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.

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