Customer Service Representative I

Primary Location Corona, California Worker Location Remote Job Number 1325670 Date posted 04/25/2025

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Description:

“This position represents {25} openings.”

Job Summary:

The Customer Service Representative is responsible for increasing customer satisfaction and retention by providing members, customers, patients and providers with accurate, consistent, timely and meaningful information. They will provide support to members inquiries and issues as they utilize the KP plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.

Essential Responsibilities:

Available to handle member inquiries regarding:

Member Core: Facility Inquiry, Web Support, Promote KP.Org, Order ID Card, Complaint, ID Card Inquiry, Service Review.

Member Adv.: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults.

Medicare: For up to two regions.

Premium Billing Enterprise: Billing Inquiry, Make Payments, Complaints, EFT Inquiry, General, Reinstatement Request, Service Review, KPC Billing, 1095 Tax Form, SLP* (*escalations to Tier III)

Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues.

Responds professionally to inquiries from internal/external customers.

Initiates contact with the appropriate Health Plan, medical group and facility personnel to obtain information relevant to the concern or inquiry as needed.

Evaluates data to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery.

Documents according to procedure.

Follows established procedures to meet customer/member needs.

Required to effectively interact with diverse work units and relevant organizational departments.

Has substantial understanding of the assigned skills and applies knowledge and skills to complete a wide range of tasks.

Ability to understand relevant policies, processes and customers.

Assist the department in meeting customer needs and reaching department expectations.

Completes required training and understand how to use tools available to recall necessary information.

Develop a full awareness of the way performance and actions affect members and Member Service Contact Centers (MSCC) performance guarantees (call handling, first call resolution, complaint resolution compliance, member retention, and return contact as warranted).

Promotes, ensures and provides customer service to internal/external customers by demonstrating skills which are consistent with the organizations philosophy of providing extraordinary customer relations and quality service.

Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, and protects the assets of the organization.

Performs other relevant duties as required.

Basic Qualifications:

Experience

Minimum two (2) years of customer service experience required or KP member-interacting experience.

Education

High School Diploma or equivalent (GED)

License, Certification, Registration

Additional Requirements:

Minimum typing speed of 30 WPM (Typing test must be current within one (1) year of the posting period).

Must pass knowledge checks while in training.

Must pass Classification Assessment

Excellent written and verbal communication skills

Demonstrated analytical and problem-solving skills.

Working knowledge of systems used within the MSCC.

Ability to read and respond briefly, clearly and effectively.

Ability to think critically and problem solve.

Preferred Qualifications:

Call Center Experience

Health Insurance Experience

Notes:

24/7 call center.

Shifts are awarded by seniority.

Staff could work any 8-hour shift within that timeframe.

Schedule to include rotating weekends, holidays and floating within the established seniority section.

Primary Location: California,Corona,Corona Member Service Call Center Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun Working Hours Start: 10:30 AM Working Hours End: 07:00 PM Job Schedule: Full-time Job Type: Standard Worker Location: Remote Employee Status: Regular Employee Group/Union Affiliation: B05|USW|Local 7600 Job Level: Entry Level Department: Regional Call Center - Corona Call Center - 0315 Pay Range: $25.33 - $27.94 / hour The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted. Travel: Yes, 5 % of the Time Remote: Work location is the remote workplace (from home) within KP authorized states. Worker location must align with Kaiser Permanente's Authorized States policy. At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.

Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.

For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:

Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.

Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty, shows consistency in words and actions; follows through on commitments.

Job duties with at least occasional or possible access to: (1) patients, the general public, or other employees; (2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (4) controlled substances regulated by federal law or potentially subject to diversion.