CALL CENTER CUSTOMER SERVICE REPRESENTSTIVE

LOCATION: JOHN H. STROGER HOSPITAL- CHICAGO IL

DEPARTMENT: MEDICAL APPLICATION ASSISTANCE

SHIFT: DAYS 10:00 AM- 6:00 PM



JOB SUMMARY: UNION
The Call Center Customer Service Representative (CSR) is responsible for call center-based education, proactive outreach, and enrollment of eligible enrollees into the financial assistance programs. Ensures that enrollees understand the financial assistance programs available i.e., charity care, Medicaid, and health insurance available through the Affordable Care Act (ACA). Utilizes knowledge of the Finance Revenue Cycle Department's policies, procedures, and guidelines as well as Medicaid/Redetermination Process, and Managed Care to handles patient complaints and propose suitable solutions. Utilizes best practices and performs all duties in accordance with Cook County Health & Hospitals System (CCHHS) and departmental standards, policies, and procedures.
This position is exempt from Career Service under the CCH Personnel Rules

Typical Duties

• Educates Medicaid enrollees of plan options including information on the mandatory managed care
  choice process
• Assists non-Medicaid individuals with application screening questions and details on how to apply
  for financial assistance programs
• Answers questions from patients, providers and the public seeking information and assistance with
  redetermination process and form completion; creates a three-way call with Illinois Medicaid
  Redetermination Project staff to support the caller's inquiry
• Provides information and assistance for re-instating or re-applying for coverage to those who have
  recently lost Medicaid or cash assistance coverage due to failure to complete in a timely manner
  the redetermination process
• Offers information on other resources or coverage for those who are not eligible for Medicaid or
  financial assistance programs
• Verifies demographic information of applicants and members for inbound calls for the purpose of
  updating with the State of Illinois Department of Health Services, Third Party Administrators, and
  other payors as necessary
• Communicates with quality assurance, patient relations, and patient advocates to support the
  commitment to quality customer service
• Escalates complex customer inquiries or complaints to the supervisor or manager
• Makes corrections to selected registration errors identified by during the quality review process
• Performs other duties as assigned

MINIMUM QUALIFICATIONS

• High School Diploma or GED is required.
• A minimum of two (2) years of experience associated with screening/processing of individuals seeking Medicaid, SNAP, cash assistance, charity care, or other related social services is required.
• Must be able to travel to work sites throughout Cook County

PREFERRED QUALIFICATIONS

• Associate's degree or equivalent from college or technical school is preferred.
• Three (3) years of experience associated with screening/processing of individuals seeking hospital system or Medicaid managed care plan is preferred.
• Prior experience in Medicaid, managed care, or human services with customer contact by telephone is preferred.
• Call Center experience in a healthcare related organization is preferred.
• Bilingual in one or more of the following: English/Spanish, English/Polish, English/Mandarin or English/Arabic (May be required based on need)

KNOWLEDGE, SKILLS AND ABILITIES

• Thorough knowledge of web-based application processing system, Cerner, eligibility verification system, Illinois
  Department of Human Services application benefits eligibility systems
• Proficiency with Microsoft Office Suite
• Excellent verbal and written communication skills necessary to communicate with all levels of staff and a patient
  population composed of diverse cultures and age groups
• Strong interpersonal and team skills
  
• Strong customer service skills
• Ability to maintain confidentiality and adhere to HIPPA standards
  
• Demonstrate strong customer service, email, and phone etiquette skills with strong response times
  
• Demonstrate analytical and organizational, problem-solving, critical thinking, and conflict management/resolution skills
  
• Demonstrate attention to detail, accuracy, and precision
  
• Ability to Educate Medicaid enrollees of plan options including mandatory managed care choice process
  
• Ability to complete