Customer Care Representative

At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high-quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together.

Umpqua Health strongly encourages applications from candidates of color as well as veterans, aiming to foster a work environment that is linguistically and culturally diverse and inclusive. Please note that at this time, Umpqua Health does not offer visa sponsorship.

As a Customer Care Representative, you will play a vital role in ensuring our members receive the support they need. You'll engage with members daily, answering inquiries about benefits, eligibility, and claims processing with empathy and accuracy. From assisting with in-person visits to handling written and telephonic communications, you'll be at the forefront of our commitment to providing proactive and responsive service. This role isn't just about answering calls—it's about building relationships, advocating for our members, and contributing to their overall healthcare experience. Join us in making healthcare more accessible and compassionate for everyone we serve.

Why Choose Umpqua Health?

Impactful Work: Make a difference in our community by helping members navigate their healthcare needs.

Supportive Environment: Join a collaborative team committed to your success and professional growth.

Comprehensive Benefits: Enjoy competitive pay, medical/dental/vision insurance, and opportunities for advancement.

Innovative Culture: Contribute to ongoing process improvements and technological advancements in healthcare service delivery.

• Assist members via various channels (in-person, phone, written) with inquiries about benefits, eligibility, and claims.
• Initiate outbound calls for welcome and retention, providing proactive service.
• Research and resolve member issues related to health plan eligibility and benefits with accuracy and empathy.
• Work closely with internal teams, providers, and regulatory bodies to ensure seamless service delivery.
• Maintain detailed records in our Call Tracking system and uphold confidentiality per HIPAA guidelines.
• Propose and implement process enhancements to elevate service quality and efficiency.
• Advocate for members by understanding their needs and concerns, and escalating issues appropriately to ensure prompt resolution and member satisfaction.
• Guide members through complex healthcare systems, explaining coverage details, and assisting with navigating healthcare resources and options.
• Demonstrate cultural sensitivity and understanding in interactions with members from diverse backgrounds, ensuring equitable service delivery and support.
• Perform other duties and support deliverables as assigned by the organization to help drive our Vision, fulfill our Mission, and abide by our Organization’s Values.

• High school diploma or equivalent required; additional coursework or certifications related to healthcare or customer service preferred.
• Demonstrated experience in customer service, preferably within a healthcare or insurance setting, with a strong understanding of customer relationship management.
• Excellent communication skills, both verbal and written, along with proficiency in problem-solving and using computer systems for data entry and retrieval.
• Empathetic listener with a keen attention to detail, dedicated to delivering exceptional service and fostering positive member experiences.

• Ability to adapt quickly to changes in procedures and policies, ensuring effective handling of member inquiries and service requests.
• Collaborative attitude with a willingness to work closely with team members, providers, and stakeholders to achieve shared goals and deliver seamless service.

Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.