_*People are the most important asset of Imperial*_, _for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization.
Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever change and business sustainability.
_
Imperial Health Plan of California, Inc.
is approved by California Department of Managed Health Care to offer full-service Medicare Advantage coverage, including a Medicare Advantage Prescription Drug plan, and a Chronic Condition Special needs plan over numerous counties in California.
Through its affiliates, Imperial Insurance Companies and Imperial Health Plan of the Southwest, Imperial also offers covered services to eligible individuals under the Affordable Care Act-Obamacare in numerous counties in Texas, Utah, Nevada and Arizona.
_*Our Mission:*_ _To deliver valuable care so that members are healthy in body, mind, and spirit to achieve their inherent potential.
_
_*Our Vision:*_ _To deliver value based care that is clinically effective, sustainable, and achieves exceptional outcome.
_
Responds to telephone inquiries from beneficiaries and providers with information and assistance with eligibility status, benefits, co-pays, co-insurance, deductibles, claims status, claims payment/recovery thru internal system, plan website, designated portals and/or thru direct contact with the plans.
Documenting inquiries and responses in the system and making changes to member records per departmental policy and procedures.
Assist and direct members and providers in an empathetic and caring manner, efficiently and timely.
Respond to provider inquiries and attempt to resolve provider concerns.
*ESSENTIAL JOB FUNCTIONS:*
1.
Documents all communications involving beneficiary and provider contacts.
2.
Answer incoming calls from our customers to include but not limited to members, providers, health plans, insurance brokers, and hospitals in accordance with HIPAA guidelines.
3.
Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer system.
4.
Advises management on issues and opportunities regarding workflows.
5.
Coordinates complete resolution of service issues by interfacing with other departments including Eligibility, Benefits, Claims and any other departments internally.
6.
Learns required measures of health information regulations.
7.
Develops an understanding of the grievance and appeals process available to dissatisfied beneficiaries and providers.
*EDUCATION/EXPERIENCE:*
· High school graduate or equivalent.
· 1 year call center/customer service exp in a healthcare setting
*SKILLS/KNOWLEDGE/ABILITY:*
· Excellent phone etiquette/skills
.
Medical terminology
· Ability to multitask and problem solve in a fast-paced work environment.
Job Type: Full-time
Pay: $19.
00 - $20.
00 per hour
Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Health insurance
* Paid time off
* Referral program
* Vision insurance
Experience level:
* 1 year
Shift:
* 8 hour shift
Weekly day range:
* Monday to Friday
Work setting:
* In-person
* Office
Ability to commute/relocate:
* Pasadena, CA 91106: Reliably commute or planning to relocate before starting work (Preferred)
Work Location: In person
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