Job Details
**Customer Care Representative (Medicare Advantage Operations)**
**Requisition #:** 481323
**Location:** Johns Hopkins Health Care, Hanover, MD 21076
**Category:** Clerical and Administrative Support
**Work Shift:** Day Shift
**Work Week:** Full Time
**Weekend Work Required:** Yes
**Date Posted:** Feb. 8, 2022
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.
**Multiple positions available. This can be a virtual work position depending on the State of residence. Must reside in one of the following to be considered: MD, VA, FL, PA, DE or District of Columbia.**
***Some weekend and night work will be a requirement for this position-October1 to March 31 annually***
Reports to the Customer Care Supervisor (MA) and under minimal supervision ensure customer satisfaction by providing timely and accurate information when responding to customer/member inquiries. Must provide thorough documentation of inquiries and ensuing paperwork and coordinates with other departments as required in obtaining solutions.
**Requirements:**
**Education**
* High school diploma or equivalent
**Knowledge**
* Work experience includes at least 2 years call center/Health Care experience. Work requires thorough knowledge and understanding of managed care and medical terminology in addition to CPT codes.
**Skills**
* Answer Medicare Advantage inbound calls compassionately from MA members, MA member representatives and providers
* Call types may vary from benefit eligibility, enrollment, to claims status
* CCRs must be able to focus on MA member needs by demonstrating strong listening and patience skills
* CCRs are responsible to complete research utilizing all available resources to ensure accurate and exceptional customer service is being delivered within CMS guidelines while adhering to departmental internal policies and procedures
* Ability to work independently, honor commitments to our members, and collaborate with team members to promote a remarkable member experience while achieving first call resolution with our members
* Ability to navigate multiple systems while resolving complex issues as advocates for our members
* Demonstrate a passion for providing exceptional customer service impacting STARs ratings
* Strong verbal/written communication skills
* Willingness to adapt to change/demonstrate flexibility
* Outbound calls are periodically required for surveys and resolution of outstanding issues to support Johns Hopkins Advantage MD program.
* Clear and concise verbal and written communication skills.
**Work Experience**
* High school diploma or GED
* 2-3 years of customer service experience
* Knowledge of professional telephone etiquette and soft skills
* Analytical and problem solving skills
* PC proficiency to include Microsoft Office Excel, Word and Outlook
**Machines, Tools, Equipment**
* Must be able to operate general office and communication equipment (i.e. head set).
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.