Job Description

Job Title: Bilingual Health Care Concierge, Senior
Job ID: 1900010P
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Variable
Facility:
Department: Member Services
Location: 600 Grant St, Pittsburgh PA 15219

Description

The UPMC Health Plan Member Services Team is currently hiring full-time Bilingual Customer Service Concierges to be an advocate for our English and Spanish speaking members and to proudly wear the badge of UPMC Health Plan. With a close-knit work environment and a dedicated culture of service excellence, our Member Services Team educates and guides our customers through coverage, claims, and other program inquiries.

 

UPMC Health Plan has been recognized by J.D. Power and Associates for providing the “Highest Member Satisfaction among Commercial Health Plans in Pennsylvania.” That’s due—in no small part—to the compassionate attention and expert insight that our customers (which include members, providers, and facilities) enjoy each and every time they contact one of our dedicated representatives.

 

Our employees receive comprehensive benefits, and have ample opportunities for growth and advancement. As a Customer Service Concierge, you will complete a 15-week training course, which will equip you to take on even the most complex customer needs. After training, you will work Monday through Friday between the hours of 7 a.m. and 9 p.m., depending on assignment, with rotating Saturday shifts of 8 a.m. to 3 p.m.

 

Join our award-winning family. Apply today to become a Customer Service Concierge!


  • Provide impeccable customer service by being proactive and responsive to all UPMC Health Plan internal and external customer requests.
  • Ability to understand and effectively communicate information regarding three product lines or function including benefits and claims information.
  • Remain current on all departmental policies, procedures, plan benefit designs, and modifications.
  • Communicate effectively with excellent verbal and written interactions/skills.
  • Identify root cause for member issues and seek resolution with our internal departments.
  • Serve as a role model of service excellence by supporting a positive call center atmosphere.
  • Drive First Call Resolution on every inquiry by completing all necessary outreach calls on behalf of the member.
  • Assist with the first call recovery process as needed for service recovery initiatives.
  • Manage multiple member inquiries across interaction types including telephonic, fax, online, chat, web messages and email.
  • Service multiple product lines and complete cross training to meet the needs of the business.
  • Attend all member service meetings, trainings and power summits as scheduled.
  • Service and document inquiries in accordance with UPMC Health Plan quality guidelines.
  • Serve as a mentor to newly hired staff members to role model excellent customer service, documentation and follow-up as required by the department.
  • Follow up on and document actions required to service inquiry from UPMC Health Plan members, prospective members and providers.
    Conduct outbound service calls in accordance with departmental initiatives.
  • Provide exemplary customer service by being proactive and responsive to all UPMC Health Plan customer requests.
  • Claims interpretation skills with the ability to learn and understand claims processing.
  • Support team members by assisting on the Resource unit and provide coaching as needed and identifying potential training opportunities.
  • Investigate, document, and bring to resolution, all customer inquiries in accordance with UPMC Health Plan Resource Unit's guidelines.
  • Support other departments as needed.
  • Must be flexible with responsibilities and have an exceptional ability to multitask.


Qualifications

  • High school graduate, Associates or college degree preferred.
  • Minimum of 3.5 years of customer service experience required.
  • 1.5 years health insurance call center experience or Bilingual.
  • Internal UPMC Health Plan experience preferred.
  • High level knowledge of health insurance on 3 lines of business preferred.
  • Ability to identify root cause, escalate and resolve complex member issues.
  • Thorough understanding of Member and Provider Services and all health plan entities.
  • Ability to mentor new hires to be successful and identify areas of opportunity for training and development.
  • Ability to schedule and conduct power summits amongst the team.
  • Demonstrate a positive and professional attitude.
  • Preferred knowledgeable in medical terminology, diagnosis and procedure codes.
  • Thorough understanding of claims processing required.
  • Excellent written and verbal communication skills.
  • Proficiency in typing is required.
  • Ability to make independent decisions.
  • Knowledge of Microsoft Office, Access and Excel spreadsheet program preferred.
  • Excellent organizational skills.
  • Maintain an excellent attendance and punctuality record.
  • Flexibility in work schedule to manage the queue in the evenings and on the weekends.
  • Fluency in Spanish is strongly preferred.

Salary Range: $16.72 to $26.54 / hour

Union Position: non union

Apply Current Employee?

UPMC VALUES

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

QUALITY & SAFETY
DIGNITY & RESPECT
CARING & LISTENING
RESPONSIBILITY & INTEGRITY
EXCELLENCE & INNOVATION

UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.


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