About Our Company

At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. At Altais, we're building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include: Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.

About Your Team

Are you looking to work with a high performing, fast growing and dynamic Care Management team? Altais and our subsidiaries, form one of the most recognized medical groups in California. We are 4,000+ physicians, working in over 40 cities in California, caring for more than 500,000 patients. If working in a mission driven organization supporting highly competent, hard-working, thoughtful clinicians who value good ideas and are passionate about reshaping healthcare excites you, then we are thrilled to welcome you to your new career.

About Your Work

The Customer Service Specialist role is responsible for the effective and thorough handling of telephonic inquiries from all Altais customers. Accurately responds to inquiries on Altais policies regarding calls for claim status, adjustment, authorization, referral, eligibility, network composition or access and quality of care. Tracking of all inquiries and appropriate follow-up are required. Works with Altais departments in the resolution of all customers inquires in a timely and professional manner.

You will focus on:

• Responsible to answer incoming calls for Customer Service, Referral Services, PPO claim departments, and ACD queues.
• Document all call information into EPIC CRM.
• Coordinates with internal and external stakeholders to obtain necessary information to resolve customer inquiries, escalates issues as appropriate to Lead, Supervisor or Manager.
• Provide education and assist in trouble shooting to offices related to enrollment and appropriate use of EpicLink.
• Adhere to established production, quality standards and work schedule.

The Skills, Experience & Education You Bring

• Demonstrate ability to resolve telephonic inquiries satisfactorily and maintains professional relationships with all Altais customers both internal and external striving for excellent customer service.
• Demonstrate ability to utilize appropriate reference materials when answering all inquiries; listen attentively to customer issue(s) and deciphers customers' needs to resolve in a professional and thoughtful manner.
• Demonstrate ability to research basic issues and follow up with providers or members within the established turnaround time measures and escalate complicated issues to appropriate team members
• Demonstrate ability in oral and written communications, professional approach to problem resolution and organizational skills.
• Demonstrated ability to work as an effective team member always recognizing the need for a positive way.

Required Experience

• 1+ years of customer service experience in an IPA or HMO related setting with minimum
• 1+ years in customer service ACD software expertise such as RingCentral
• 1 + year knowledge of medical terminology, enrollment and membership activities and claims processing procedures/systems is required
• 1 + year of understanding and application of ICD-10, RVS, CPT codes, basic medical terminology

Preferred Experience

• 2 + years of Customer Service experience in an IPA or HMO related setting with minimum
• 2 + years in customer service ACD software expertise such as Cisco Finesse
• Spanish-bilingual

Required Education

• High School Diploma or GED

You Share our Mission & Values

• You are passionate about improving the healthcare experience and want to be part of the Altais mission.
• You are bold and curious- willing to take risks, try new things and be creative.
• You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
• You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
• You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
• You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.

Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate's starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate's qualifications, skills, and experience.

Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our 'CPRA Privacy Notice for California Employees and Applicants' to learn how we collect and process your personal information when you apply for a role with us.

Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of workday.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.