Job Details


Requisition Number 20-0009
Post Date 1/24/2020
Title Health Services Representative
Organization Concordia Plan Services
Job Grade 14
City St. Louis
State MO
FT/PT Full Time
Description

Organization Profile

  • Concordia Plan Services ‘walks together’ with LCMS ministries by providing quality benefits and services that support the physical and financial health of members and their families.

 

Reporting Relationships

  • Health Services Representative reports to Manager, Health Services.

 

Essential Job Functions

  • Serves as escalation point (tier 2) contact providing a positive, knowledgeable customer experience for church workers and employers.
  • Communicates detailed information about the Health Plan provisions and administrative policies.
  • Acts as an advocate for the member when needed and resolves questions and issues related to plan provisions with internal and external stakeholders.
  • Uses multiple systems, including vendors systems, to research and respond to member and employer inquiries.
  • Exercises discretion and judgment in handling all confidential matters.
  • Analyzes Health Services data and prepares documents and reports.
  • Creates and maintains documents and records to establish member history.
  • Collaborates with vendors to identify deficiencies and resolve issues.
  • Completes projects as directed by department manager.
Requirements

Education and Experience

  • High School diploma or associate’s degree with equivalent work experience, required.
  • Bachelor’s degree, preferred.
  • Experience in customer service, required.
  • 3+ years of experience in healthcare, preferred.
  • Experience managing time-sensitive processes, deadlines, etc., with empathy and compassion.

 

Competencies (Knowledge, Skills and Abilities)

  • Strong knowledge of Federal HIPAA regulations. 
  • Knowledge of basic principles of Health Care Reform.
  • Communications:  ability to articulate information simply and concisely; strong verbal fluency and writing skills.
  • Organizational savvy:  ability to navigate effectively in highly regulated industry and with complex organizations required.
  • Problem solving:  uses logic and methods to solve difficult problems, is excellent at objective analysis, and engages others in analyzing and developing solutions.
  • Results oriented:  steadfastly pushes self for results, self-motivated with the ability to effectively prioritize and execute tasks with minimal supervision, maintains focus on organizational goals. 
  • Systems fluency:  simultaneous command of multiple systems and collaborative tools (websites, social media, SharePoint, Pinnacle, Lawson, Benefit Administration System), skilled in use of MS Office suite. 
  • Performance management and development: sets clear goals and objectives, cooperates and participates fully in the coaching process, and actively seeks continuous learning to improve personal and team performance.
  • Customer orientation:  demonstrates a high commitment to the organizational mission by applying core concepts and principles of customer service; is dedicated to meeting the expectations and requirements of members and employer requests. 
  • Team work: participates fully on assigned and adjunct teams, fosters a collaborative spirit, builds collaborative networks with internal and external stakeholders.  
  • Change management: is energized by change and welcomes new opportunities, quickly learns and adapts to change, personal maturity to evaluate and manage uncertainty and stress effectively.  Ability to identify change opportunities. 
  • Learning agility:  learns new skills easily, climbs learning curve rapidly, applies new knowledge quickly, and seeks ways to develop self to meet new challenges.
  • Sensitivity:  practices high level of confidentiality, serve as liaison with individuals in crisis; maintains appropriate balance between compassion, encouragement, and accommodation while at times being able to deliver a difficult message.  
  • Social / interpersonal skills: interacts effectively with a wide variety of people; respectful and maintains the dignity of others; amicable; fosters differing opinions and values input from various perspectives.

 

Supervisory Responsibility

  • Health Services Representative does not have direct reports or supervisory responsibility.
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