Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHC is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC has become a leader in provider-sponsored health plans and is poised for future growth.
Many organizations talk about transforming the future of healthcare, Johns Hopkins HealthCare is actually doing it. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for the members and communities we serve. If you are interested in improving how healthcare is delivered, join the JHHC team.
Position Summary:
The Johns Hopkins Customer Service Representative position is a professional position that answers incoming customer inquiries from John Hopkins Healthcare members, providers and internal stakeholders. Customer inquiries can be received via Calls, letters and/ or other electronic means such as skype or chat. This key position actively works to listen and comprehend questions, offer accurate information, resolve problems, professional respond to all inquiries and comprehensively document the customer interactions in JHHC's customer service database(s). This position requires strong communication skills both verbal and written, good problem solving skills, a professional demeanor with consistent and timely attendance. This position is available for telecommuting (equipment provided) upon successful mastery of systems and ability to meet performance standards.
Working with call center management, QA and our dedicated training team(s), the CSR will stay updated on product, compliance and service offerings, remaining knowledgeable and informed of all policies. This position provides feedback on the efficiency and opportunities regarding the customer service processes.
Upon completion of training, CSR must be able to demonstrate competency and mastery of the various JHHC Healthcare databases and tools required as part of the CSR position.
A. Education:
High school diploma or equivalent. Some college is helpful.
Knowledge:
B. Knowledge (Continued)
B. Knowledge (Continued)
Minimum requirements to be removed from Probationary Status:
To successfully complete probationary period with JHHC, CSR1 position must have solid working knowledge of supported medical plan and the JHHC systems being able to demonstrate adequately navigating systems and resolving member inquiries, claims issues, denials and adjustments and provide accurate and understandable explanation to members.
Must meet all attendance, quality and performance guidelines
Maintaining or exceeding a 96% Q/A rating for two consecutive months after maintaining or exceeding a 96% Q/A rating for six (3) consecutive months from date of hire
Requirements for promotional consideration:
Must have met all performance expectations
Maintaining or exceeding a 96% Q/A rating
Maintaining or exceeding an average of 50 or more calls per day
Must meet or exceed attendance guidelines
Must have demonstrated behaviors that support a positive and professional work environment
Acts as a team player at all times - demonstrating a willingness to help, team work and collaboration
Operates with integrity in all work efforts
Is respectful and professional in all interactions
Must not be on any Performance Improvement Plan or Disciplinary Action for any reason
Must have maintained case work consistently and within appropriate timeframes
Customer Service Representative (Telecommuter) this position has the opportunity to work from home.
All hardware will be provided; i.e. PC, Telephone, though a network router and a high speed internet connection must be in place prior to the representative working from home.
The telecommuter representative must meet requirements before being selected to work from home
Performance expectations are maintaining or exceeding a 95% Q/A rating for six (6) consecutive months from date of hire
Maintaining or exceeding a 98% Q/A rating
Maintaining or exceeding a 90% Availability rating
Must have been a level I CSR for at least three (90 days) months and have met all performance expectations for that period
Must have demonstrated behaviors that support a positive and professional work environment
Must not be on any Performance Improvement Plan or Corrective Action for any reason
Must have maintained case work consistently
If the representative is placed on a Performance Improvement Plan or Disciplinary Action for any reason, ability to work from home may be revoked
C. Skills:
Ability to foster and maintain professional relationships over the phone, in written correspondence and via other electronic modes
Ability to maintain a calm and professional demeanor
Must be able to competently and efficiently work within multiple databases, tools and processes throughout a customer inquiry
Organizational skills with the ability to manage numerous projects and priorities at once
Ability to thrive in a fast-paced and sometimes high-production environment
Basic Knowledge of MS Word and Excel
Strong problem solving skills
Willingness to work independently or as part of a team
Ability to learn medical terminology
Able to work with highly confidential information
Solid follow-up skills and attention to detail
E. Work Experience
Minimum 1+ years of experience in a production style customer service-related role
Collaboration -Develops productive relationships that support work goals
Accountability - Takes responsibility for own work
Practices active listening
Fair and equitable in all responses
Adheres to all compliance rules, policies and standards
F. Machines, Tools, Equipment:
Must be able to operate general office and communication equipment (i.e. head set).
Must have basic computer skills and data entry skills; to advance computer skills as defined in higher level CSR positions.
Dimensions:
A. Budget Responsibility:
Effectively uses resources within own control.
B. Authority/Decision Making Level:
Prioritizes own workload, works with supervision and approval from supervisor
Problem Solving:
Uses defined procedures to handle customer inquiries and complaints.
Uses defined procedures to handle customer inquiries and complaints. Uses accurate judgment and is able to problem solve situations in a timely, accurate fashion, demonstrating professional demeanor at all times. Uses departmental policies, procedures and protocols to evaluate and determine the best alternative as it pertains to all aspects of responding to member and provider inquiries.
Information Management:
Skill Sets; including, though not limited to: Microsoft Office Suite including Word and Excel, and Healthcare Database Systems
Must be able to use and understand verbal, written, and electronically displayed information in healthcare databases and utilizing the phone systems
Must be able to follow established departmental and company-wide policies and procedures.
Must have adequate typing and computer skills to successfully navigate healthcare databases.
Working Conditions:
Works in a normal office environment where there are no physical discomforts due to dust, dirt, noise and the like.
Work is sedentary in nature; however, some standing, stooping, and bending and walking is required.
Required keyboard activity, pulling and duplicating.
Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.