Bilingual Multiple Prod Phone Rep I

Health Net, Inc. (NYSE: HNT) is among the nation's largest publicly traded managed health care companies. Health Net's mission is to help people be healthy, secure and comfortable. The company's POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company's Web site at www.healthnet.com



JOB SUMMARY:


Under general supervision, responds to routine telephone inquiries from members and employer groups, to provide information and clarification on multiple products. Provides routine information on multiple product claims and member issues while maintaining required performance standards. Handles routine member issues involving multiple products related issues.


ESSENTIAL DUTIES AND RESPONSIBILITIES:

Provide prompt, accurate and excellent service to internal and external customers.

Meet or exceed established departmental performance goals.

Receives incoming calls involving routine inquiries involving multiple products from member, providers and employer groups, while maintaining quality and productivity standards.

Responds to routine inquiries on multiple products relating to eligibility, pharmacy, claims and provider services.

Contacts physician groups, IPA's and physician provider offices.

Works to enhance relationship with Health Net business partners.

Coordinates, processes and documents PCP/PMG transfers utilizing appropriate protocols.

Utilizes multiple company database programs for accessing member information.

Sends out requested material such as: provider directories, mail-order pharmacy information and travel kits.

Updates members' addresses and phone numbers in the data system.

Orders member identification cards, as needed.

Facilitates the filing of grievances through accurate and timely collection of information.

Handles difficult phone inquiries from irate or emotionally upset members distraught over physical or psychological condition.

Determines appropriate resolution, calms the member, and provides or solicits appropriate help.
REQUIREMENTS


REQUIREMENTS:


Education:

High School diploma or equivalent

Experience:


Knowledge, Skills & Abilities:
Proven excellence in customer service techniques.

Thorough knowledge of HMO and other single product benefits, internal processes, policies and procedures relating to membership, claims and experience with Health net automated systems to access claims, eligibility, correspondence and related information.

Ability to operate PC based software programs or automated data base management systems including ability to learn FH Windows for multiple products.

Knowledge of correspondence and PMG transfer procedures preferred.
Bilingual English and one of the following languages: Spanish, Cantonese, Mandarin, Russian is required.

OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.











Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.











Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.