Customer Service Representative

Reporting to the Sr. Manager of Health Plan Operations, the Welbe Advocate I is responsible for two primary functions within the Welbe Advocate Hub, based on assignment. A Welbe Advocate I may be assigned to either inbound and/or outbound assignments within the Hub which could include but not be limited to call management (answering inbound calls), outbound scheduling, authorization processing,inquiry response, clinic-based scheduling and/or other administrative tasks. The Welbe Advocate I will provide outstanding customer service to all stakeholders (participants, families, partners, and team members) and will be responsible for proper documentation and maintaining current and accurate records of all the scheduled appointments. The Welbe Advocate I role requires ability to work in a fast paced, participant centric environment. The Welbe Advocate I must be comfortable with multitask work dynamics while still able to
collaborative effectively with colleagues and stakeholders to promote the WelbeHealth values,team culture and mission.

What you’ll do:

• Answer incoming phone calls, emails, contacts as requests coming into the Hub.
  Appropriately screen, transfer, resolve and dispose of calls expeditiously which adhering
  to all process and documentation standards.
  • Review, process, schedule and authorize orders according to department protocols.
  • Ensure that appropriate and timely documentation of all updates, encounters and
  communication is documented in source systems as outlined by department protocols.
  • Effectively coordinate the scheduling of participants appointments, including troubleshooting conflicts or urgent needs, communicating with all stakeholders (staff, family, providers etc.) and meeting appointment turn-around times as outlined in WelbeHealth Appointment Scheduling Protocol.
  • Respond to questions and inquiries regarding authorization status and requirements.
  • Provide eligibility status and benefit information for participants.
  • Collect/Update and Verify Participant and Provider information as required.
  • Address both participant and provider inquiries and if unable to resolve, escalate as
  appropriate.
  • Conduct appointment confirmations and appointment reminders as outlined by department
  protocols, updating appointments as appropriate.
  • Maintain current and accurate records of all scheduled appointments – scheduled times,
  outcomes (e.g., appointment occurred or not, reasons for rescheduling).
  • Trouble-shoot and resolve basic issues; escalate to manager when appropriate.
  • Complete all required documentation in a timely and accurate manner.
  • Protect privacy and maintain confidentiality of all company procedures and information
  about team members, participants, and families.
  • Follow WelbeHealth policies and procedures and participate in any required Quality
  Improvement activities, staff training and meetings.
  • Communicate regularly with Supervisor and team regarding workload and priorities.
  • Timely completion of all mandated trainings and education.
  • Timely completion of all mandated occupational health screenings as needed.
  • Exercises flexibility in performing assignments as business needs evolve.
  • Other duties as assigned

Why you’ll love working at WelbeHealth:

• You will play a critical role in bringing the ground-breaking WelbeHealth PACE model of care to scale, providing much needed services to a vulnerable population
• You’ll be joining a company that combines the best of mission-driven orientation with innovation, with the opportunity to help shape our programs and processes as we grow
• You’ll be surrounded by capable colleagues who care deeply about their work and are greater than the sum of our parts

Your qualifications:

• Preference for Southern California based team members, who would be open to potentially work on-site within our markets in the future, dependent on the business and operational need. 
• Minimum of one year experience working in a call center environment where a
  service/support role was primarily performed.
• Minimum of one year experience working in health care or PACE setting a plus.
• Outstanding customer service orientation, especially in telephone and written
  communications.
• Excellent and accurate data entry skills and experience in multiple software platforms.
• Ability to work independently with minimal supervision.
• Bilingual English/Spanish preferred
• Deep commitment to helping unlock the potential of our most vulnerable seniors.