Customer Service Representative -Bilingual

Position Summary

The Customer Service Representative I - Bilingual role is the initial point of contact for members of Care Oregon and provides excellent customer service delivery relating to the Oregon Health Plan (OHP), Medicaid or Medicare, Group and Individual Medical, Dental, and Mental Health. This entry level position typically focuses on responding to member inquiries but may also assist with outbound calls.

This position is eligible for 3% bilingual pay.

Salary: $18.45 - $22.55 per hour

SIP Target, 5% Annual

• Research, verify and resolve inquiries related to Oregon Health Plan (OHP) or Medicare eligibility with guidance from Supervisor and Customer Service Operations Specialists.
• Respond and assist members with Primary Care Provider (PCP) assignments.
• Learn to collaborate with others within Customer Experience and other Care Oregon departments to service the member customers and explain OHP or Medicare benefit coverage; provide additional information about community resources when appropriate.
• Collaborate with providers, Division of Medical Assistance Programs (DMAP), and members to ensure effective customer service and the resolution of any health plan issues that arise (e.g., issues with eligibility and systems, etc.).
• Use Call Tracking system to document all communications and activities in relation to members, providers and other customers.
• Maintain confidentiality for all members.
• Coordinate mailing of member materials as needed.
• Treat all members with honesty, courtesy, dignity and respect.
• Provide members with professional, timely, and competent service.
• Identify and report any system or process issues; contribute suggestions for improvement.
• Consistently meet or exceed Care Oregon Customer Experience standards and expectations related to quality, production and attendance.
• May assist with outbound calls to Medicaid or Medicare members such as welcome and retention calls.

• Minimum 1 year experience working in customer service or health care.
• Fluency through language testing in a second language relevant to the population served.

• Work experience in a call center.

• Ability to learn and apply Oregon Administrative Rules (OARs), Federal laws and other regulatory agencies that relate to the medical health insurance industry and the Medicaid or Medicare industry.
• Strong computer application skills including MS Windows, Word, Excel and Outlook; comfort navigating through multiple documents and internet browser.
• Ability to type minimum 35 words per minute preferred.
• Strong written and spoken communication skills.
• Ability to speak English, as well as a second language relevant to the population served.
• Strong customer service skills.
• Ability to interact professionally, patiently and courteously with members in writing and on calls.
• Strong active‑listening skills.
• Growing ability to articulate complex issues clearly and understandably.
• Ability to provide clear and concise information and directions as well as follow instructions.
• Ability to proactively learn department processes.
• Ability to commit to continual improvement in quality and productivity.
• Ability to participate fully and constructively in department meetings.
• Ability to work in a fast‑paced environment and manage multiple tasks.
• Research, analytical and problem‑solving skills.
• Ability to adhere to a set schedule and maintain excellent attendance.
• Ability to work effectively with diverse individuals and groups.
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions.
• Ability to accept direction and feedback, as well as tolerate and manage stress.
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day.
• Ability to hear and speak clearly for at least 3‑6 hours/day.

Work Environment(s): Indoor/Office.
Member/Patient Facing: Telephonic.
Hazards: May include, but not limited to, physical and ergonomic hazards.
Equipment: General office equipment.
Travel: May include occasional required or optional travel outside of the workplace;…