What are your best practices around documenting member calls?

"I know in healthcare if it's not documented, it didn't happen. I also understand that when members call back, peers need my documentation to guide members smoothly through their engagement. It can be incredibly frustrating for members to repeat their problem several times, and solid documentation is helpful in ensuring they don't have to do that. As a best practice I ensure that documentation is simplistic but includes all relevant information such as dates, addresses, and doctor names. I use well-known acronyms when appropriate and make sure that I've formatted the information in a way that is skimmable with bullets and avoid using large paragraphs of information. "

When engaging with members, documentation is vital. It's a regulatory requirement and also a best practice. If the member calls back, your colleagues will have all of the relevant information they need to help the member. Interviewers are asking this to ensure you understand the value of documentation and the golden rule 'If it's not documented, it didn't happen.'

How would you support a member who just received a terminal diagnosis?

"In my current role, I recently supported a member who was advised that her husband had stage four brain cancer. This was sad and shocking news to her because her husband was otherwise very healthy. In explaining her costs associated with treatment, she became quickly overwhelmed and unconsolable. I immediately wanted to jump to solve mode and fix things for her, but I realized there was absolutely nothing for me to do. I sat with her quietly and let her cry for as long as she needed to. She started to calm down and apologized. I reassured her that there was nothing to be sorry about and cry as long as she needed to. She was so appreciative and thanked me for not making her feel bad."

In supporting members, there will come a time that you will need to support members who've recently received scary news such as a terminal illness. Kaiser interviewers are looking to see how empathetic you can be in these situations while remaining tactful and professional.

What is your understanding of the "minimum necessary rule?"

"I understand the minimum necessary rule can be very nuanced in sharing member information. An example of this is peers talking about a call they have taken or complaining about a member by name. Even when I'm permitted to discuss member information, I ensure that I am only sharing the absolute basics to protect member privacy. If a peer needs guidance, I request that they remove all irrelevant information before discussing the members situation."

The minimum necessary rule is a nuanced HIPAA guideline stating you can only share member information on a minimum necessary basis. Kaiser interviewers ask this question to see if you have a strong understanding of the rule and your ability to comply with it. Your knowledge of implementing this rule demonstrates your ability to protect member information as required by law.

Can you share your best practices for protecting PHI and follow HIPAA guidelines?

"When accessing member information, it's essential to only use it as needed and protecting it at all costs. That is not just my best practice, but that is also the law. I always ensure that I lock my computer when I walk away, I follow a clean desk policy at all times. I only discuss member information with covered entities such as their providers and only the information that is absolutely vital to share. When verifying their information, I never say their address or phone number out loud, I ask them to share with me and validate if needed. Lastly, I keep sensitive conditions in mind such as mental and sexual health since I know those topics can only be shared with member permission."

Working for Kaiser you access highly sensitive member information. Interviewers ask this question to see if you understand the sensitive nature of the information and if you know what you can and cannot do with member information. To answer this question, your answer should include your understanding of when you can and cannot use member information.

What best practices do you use during a crisis call?

"Crisis calls can be overwhelming if you are unprepared. When handling crisis calls, it's essential to be empathetic and understand that this member is going through a challenging situation. To manage crisis calls, I lean on my ability to remain calm and supportive throughout the entire engagement. I educate myself on the crisis call workflow because I know it can vary slightly. Currently, our process is to make a leader aware and to call our designated crisis hotline immediately. I stay on the call the entire time, documenting the full engagement while the leader reaches the local authorities."

When supporting Kaiser members, you support members through healthcare and financial scenarios, both of which can be overwhelming. In some cases, these calls can turn into crisis calls, where members make comments that make you fearful for their well-being. Kaiser interviewers evaluate your ability to stay calm in a stressful situation, demonstrate empathy, and follow specific policies.

How do you help a member when you don't know the answer to their question?

"I know that guidance and regulations are fluid and often changing. If a member has a question that I cannot answer, I move through a checklist of resources to see if I can find what they are asking. I start with our internal knowledge base, recent company updates, my peers, and my manager. If I am unable to find the information I need after checking those resources, I advise the member that I need to look into this a little further to ensure I am providing them with the most accurate information. I then check with relevant business owners for an update and ensure that our knowledge base gets updated."

Rules and guidance in healthcare change frequently and often. While companies do their best to ensure that all standard operating procedures are comprehensive, it is impossible to know for sure that every bit of content ever needed will be available when a member calls. To best answer, this question, demonstrate your ability to be resourceful. Interviewers are also looking to see if you can say 'I don't know' in a way that doesn't break trust with a member.

Can you tell me what steps you would take for a member who has called several times or spoken to several agents?

"I know how frustrating it can be to call and retell the same story several times. If I get a member who has been passed around, I first get a good callback number to ensure that I have a concrete way tocall them back if anything happens. I also reassure them that I will be the only person they will be speaking to moving forward and provide them with my direct contact if possible. Additionally, I take extreme ownership of their scenario and make sure that they don't have to call back at all. I investigate their issues, determine resolutions and proactively outreach them. Lastly, I determine why they were passed around in the first place to figure out if we have phone errors or if another colleague needs coaching."

Calling your healthcare company can be wildly frustrating. You often have to retell very complex scenarios multiple times and hope you get an agent who is friendly and helpful. Interviewers are asking this question to validate your level of stewardship in helping members. Kaiser is looking to see the type of ownership you take for their members in getting them the support they need.

What are you best practices for members who are difficult to understand?

"While it can be frustrating not to understand someone clearly, it can be even more frustrating not to be understood. With this in mind, I make it a best practice to always ask for clarity when needed and recap everything they have shared with the phrase 'What I hear you say is..., is that correct?' Additionally, I always follow up on the conversation in writing to ensure we are aligned on the critical details. Lastly, I provide a level of extreme patience always remaining calm as this helps the conversation run smoothly."

In taking calls from members, you engage with people from all over the world and all walks of life. However, in dealing with health care, the details are essential because you support the health and finances of the individuals you help. Kaiser interviewers ask this question because they want to know that you can be polite, diplomatic, and supportive, even when members are difficult to understand. Your answer should include your ability to be patient, kind, and confirming to best answer this question.

How do you manage extreme change?

"While change is exciting, it can also be paired with stress or fear of the unknown. When faced with constant change, it's essential to focus on the things I can control. Additionally, I must remain calm. If my peers see me worry or panic, that energy can become contagious and influence the environment. As a best practice, I evaluate what I can control, celebrate the positives, and seek support for myself if needed. I find that if I seek support for myself first, I can support my teammates better."

The health care industry is a highly regulated sector, which means that guidelines and laws change rapidly and frequently. When Kaiser interviewers ask these questions, they listen to see how agile and positive you can be in times of change. Your answer should demonstrate your flexibility during times of change and your ability to support your peers during uncertain times.

Tell me about a time you demonstrated extreme empathy with a member?

"I recently supported a member whose spouse was recently diagnosed with a brain tumor. She called to inquire about her benefits but was inconsolable, making it challenging to get the information I needed to help her. My initial reaction was to advise her that I would need her to calm down to assist her. Instead, I asked myself, how would I want to be treated in this scenario? Instead, I just sat with her. I let her cry, I didn't interject or even offer condolences. She needed to express these emotions, and I felt the best thing I could do for her was be there, quietly supporting her. She eventually began to calm, thanked me profusely, and we eventually got her the support she needed."

Supporting members who call Kaiser means that you will often be a part of life-changing events for members. Often times, members receive news regarding a new diagnosis, terminal illness, or a costly bill. You must demonstrate your ability to be empathetic to Kaiser members and navigate the information they share tactfully.

Tell me about a time you disagreed with a policy or rule and how you handled it?

"In my current position, agents are not supposed to call providers directly. Instead, they ask us to create an engagement ticket and send it to a provider support team. Unfortunately, these engagements are pretty time-consuming and take several days to get back to our members. I followed the process, but I knew this wasn't the best experience for our members. I asked if I could reach out to the provider team to amend this workflow with my manager's permission. I prepared a presentation explaining the costs and frustrations associated with this workflow. This team was receptive and is currently looking into the legal parameters of launching this new workflow."

You will not agree with every policy a company launches. It's essential to follow the rule in the pursuit of better ones. One of Kaiser's core values is a pioneering spirit, so your answer should include this core value. Additionally, your response should consist of your ability to follow the rules, even when you disagree with them, using your pioneering spirit to tactful drive for change when needed.

What does it mean to take ownership of a call?

"Taking ownership means acting as a true advocate and steward for members. A few weeks ago, I got a call from a member who was crying. She recently had foot surgery, required a second surgery, and then her doctor went out of network. Every time she called, each agent she spoke to told her this doctor was out of network, and there was nothing they could do to help her. I recognized what the member was telling me, told her I would be frustrated and reassured her I would look into this for her. After looking through all materials and connecting with supervisors, I discovered that this member had been misinformed. I realized that we broke her trust with inaccuracy, and to repair that trust, I offered to be her main point of contact if she ever needed to call back."

Kaiser strongly values stewardship which means taking ownership of a member's concerns. While the work you do as a customer service agent for Kaiser is essential to work, you are fielding high volume calls which means that members may not always get the service they deserve. For a solid answer, you should demonstrate your ability to control the environment.

Can you tell me about a time you didn't provide great customer service? How did you course correct?

"One of my core values is always to find the underlying needs of the members I assist. However, one day I was not feeling well, and I was incredibly brief with a member. They asked for an in-network emergency room, and instead of digging to find out why they needed an emergency room, I gave them the hospital name and ended the call. As soon as I hung up, I felt horrible. I felt like I failed the member and did not provide them with the experience I would have wanted. I immediately called them back to make things right. I also connected with my leader and shared what had happened. I asked my leader if I could leverage them if I ever feel this way again, and they were happy to help."

Regardless of how skilled you are, there will come a time when you do not provide excellent customer service. You may not be feeling well, having a bad day, or dealing with a difficult member. While you are not expected to be perfect, you need to demonstrate self-awareness and your ability to correct a poor interaction. To answer this question best, you should show accountability for your actions, vulnerability, and desire to improve. Additionally, give an example of resources you use to correct your mistakes.

Have you ever been given feedback you didn't agree with?

"In my current role, I recently received feedback that I needed to be more detailed in my post-call documentation. I felt a little misunderstood when I received this feedback. My notes lacked details due to trying to wrap up quickly so I could help the many members waiting in the queue.Before reacting, I challenged my initial feelings towards the feedback, knowing that feedback is a gift. I knew that my leader was providing this feedback for the betterment of our members. I shared my reasoning for brief documentation and explained the support I would need from my leader not to feel anxious about the building queue."

Kaiser believes in making each interaction extraordinary. As a Customer Service Representative for Kaiser Permanente, you function between their members, employer groups, providers, brokers, and internal customers. When Kaiser interviewers are asking this question, they are trying to evaluate how coachable you are. When supporting members, there are a lot of opportunities for improvement. You are working with members who may not be feeling well, managing a complex medical issue, or receiving life-changing news with a new diagnosis. These engagements do not always go as intended, so it's crucial that you are open and accepting of helpful feedback. To answer this question best, your answer should demonstrate your openness and desire for feedback. It should also express your ability to action feedback given to you, with a favorable outcome.

What is your strongest attribute?

"I would say that my most vital attribute is my communication skills. I've found that you can be intelligent and productive, but your other skills don't translate if you fail to communicate well. When thinking of ways to improve workflows and push the company forward, my communication skills have been an effective tool in driving change and managing stressful situations."

Kaiser interviewers are asking this question to assess if your personal values and theirs are aligned. Additionally, they are evaluating your ability to remain humble even in inherently boastful moments. When answering this question, focus on your attributes that align with the job description.

Tell me about yourself.

"I've been a customer service representative for over ten years. I've spent the last five years at a tech healthcare startup. During that time, we grew from 50 agents to over 200. This rapid growth allowed me to elevate in my role quickly, serving as a team point person and an acting mentor for three of my peers. I know that in this role, you are looking for someone who can provide extraordinary engagements with members, and that is what I do best."

You can pretty much guarantee this will be the first question asked in any interview, which really makes it the most crucial question. This sets the tone around who you are, your presentation skills, and your ability to present a lot of information in 2 minutes or less. To successfully answer this question, use the W.A.R method:W: Who You Are A: Achievements R: Results

Can you tell me about your relevant experience?

"I've been working in a customer service capacity for over five years. I've worked in the tech and health care sectors, answering member calls and responding to emails. On average, I take over 50 calls per day and have an adherence rate of over 98%. What this means for Kaiser is that I already have the foundational skills that you are looking for in this position. Your time spent onboarding me, will be more about learning the business versus training."

Interviewers are using this question to evaluate your ability to hit the ground running. You can certainly learn through training and onboarding, but they are looking to see if you have the essential basic skills of the role. To provide an excellent answer here, focus on the main components of your experience and how it translates to their position. An effective phrase here is 'and so what that means for Kaiser is...'

What do you think are the most important characteristics of a great Customer Service Specialist?

"I know here at Kaiser, and you find significant value in providing extraordinary service in every interaction with your members. This value resonates with me deeply. While there are many factors that make up a great customer service agent, I think a few of the most important are patience, stress management, and most importantly, compassion and empathy."

Since Kaiser Permanente believes in making each interaction extraordinary, since you will be the face and voice of Kaiser Permanente, they ask this question because they want to make sure that you agree on the essential characteristics of a great customer service agent. They want to qualify your values and find alignments between your values and theirs. To best answer this question, call attention to their customer service value of making every interaction extraordinary. Additionally, knowing that you will be supporting members in difficult situations, your answer should reflect your empathy and compassion.

Tell me about a time you received excellence customer service?

"I recently had to call my phone carrier, and it was incredibly frustrating. I was passed to different agents about a dozen times and was hung up on after waiting for almost an hour. When I finally got through to another agent, I was almost in tears at this point. She apologized profusely for my experience and promised me that she would not transfer me again. She also took down all of my information and said she didn't want me to have to be on the phone for one more moment and that she would investigate and call me back when she got to the bottom of my issue. I was so grateful for someone to take ownership of my problem and keep their commitment to the service they are providing. She demonstrated true stewardship, which is a personal value of mine."

Kaiser values extraordinary experiences for its members. They ask this question to ensure that you are both aligned on what excellent customer service looks like. They assess the components that you find valuable in customer service with the expectation that you will also provide that level of excellent service.

Tell me about a time you anticipated a member's needs?

"Recently, a member called and asked what their closest in-network emergency room was--knowing that members don't ask that question unless they're in an emergency, I asked the member if they were having an emergency now. It turned out that they thought they had pink-eye. I explained the costs of going to the emergency room for pink-eye and gave them low-cost and free options such as urgent care and virtual primary care. The member was so grateful not to have to wait in the ER for several hours."

Sometimes when a member calls, they aren't sure what to ask or what they will need. Kaiser interviewers evaluate to see if you can support members even when they don't know what they need themselves. This anticipatory skill is what differentiates good customer service agents from great ones. They also ask this question to evaluate your ability to big-picture think when the requests aren't explicit.

Tell me about a time you dealt with a difficult member and how you handled it?

"In my previous role, a member called because he received a bill for over $70,000 for an appendectomy. He was angry that we did not cover his surgery. Knowing that his policy was active, this was likely a mistake, but he was so upset I didn't have the opportunity to explain that. When members get to this point, I like to use the 'Three R's' approach. Recognize their issue, relate that you would be upset, and reassure them that you will help them. Using this approach, I was able to calm him down to explain why his claim didn't payout, which was an error, just as I thought."

No one is calling their insurance company because they are having a good time. If you're calling your insurance company, your likely dealing with your health or financial issues, both of which are incredibly stressful and scary. You will absolutely engage with members who are upset, not getting what they need, or reacting poorly. Kaiser interviewers need to know that you support members with a kind, empathetic and compassionate approach even on a member's worst day.

What best practices do you use to portray friendliness over the phone?

"Tone can be a crucial component when engaging successfully with members. To ensure that my friendly personality translates through a phone call, I first make sure that all of my equipment is running as intended, and I place my mouthpiece appropriately. Body language can affect your tone, so I smile when I speak and sit up straight when on calls. I listen carefully and repeat back what I hear, focusing on the member's needs."

The ability to express friendliness in your voice without saying 'I'm friendly' can be pretty challenging and is truly a skill to be mastered. Kaiser members are calling because they need your help with complex situations, and a friendly tone can feel very supportive in those stressful situations. Kaiser wants to know that you will be able to provide extraordinary care to their members, and a component of that is a friendly tonality.

Tell me about a time you disagreed with your leader and how you navigated that?

"In my current role, we had a new leader on our team. This team lead would document internal information in the member's chart. When I first made my leader aware, they were resistant and said it wasn't a big deal. Knowing the regulatory concerns around this process, I circled back with my leader again and explained the legal and regulatory implications. Additionally, I shared a similar scenario when this happened previously, and it turned into a regulatory fine. They thanked me for the feedback and shared that they didn't realize the implications and to please make them aware if something like this happened again."

It's not always possible to see eye-to-eye with every leader you report to, but a professional working relationship is not only encouraged but required. Interviewers ask this question because they want to know that you will be able to manage effective working relationships with your leaders and that you will be able to navigate engagements tactfully, even when you disagree. They are evaluating to see if you can successfully 'coach up' if the opportunity arises. Kaiser values embracing colleagues, and your answer should demonstrate your ability to do so.

How do you respond in stressful situations?

"In stressful situations, it's essential to understand your controllables and your non-controllables. I know that emotions and reactions can be heightened in stressful situations, so I opt to use the A.I.M method when I'm faced with stressful situations. First, I assess the situation, identify actionable items, and then I manage the immediate needs. Using this framework allows me to ensure that each interaction with a member is extraordinary, even in a stressful situation."

As a Customer Service Specialist, you will often need to navigate your way through stressful situations. Whether it be high call volume or a member in crisis, the interviewer asks this question to ensure that you can remain calm and support Kaiser members through stressful situations. Kaiser seeks to make each interaction extraordinary. To successfully answer this question, ensure that your answer is member-centric.

Name a time you went above and beyond for a member?

"I recently supported a member who had a tough time getting his CPAP replacement mask. By the time he got to me, he was irate. He explained that he has called every day for the past two weeks and still doesn't have a mask. I advised him that he would not have to call again and that I would call him every day with an update regardless of the situation. I diligently partnered with our durable medical equipment vendor. After almost 17 hours of calls because of network issues, I was finally able to secure his mask and was able to get it overnighted to him as well. He was very appreciative that he didn't have to retell his story every time he called."

When taking Kaiser's member calls, it's essential to keep in mind that no one calls their health insurance because everything is going great. If a member is calling, they or someone they care about is ill or needs some kind of health care support. When Kaiser interviewers ask this question, they are looking to see what level of customer service they can expect from you. They are trying to get an idea about how you will treat their members. To best answer, this question provide an example when you strongly advocated for a member (or customer). One of Kaiser's core values is stewardship, so your answer should demonstrate how you took ownership of the member's needs.

Kaiser Permanente Customer Service Specialist Interview Questions

Go Back

1. What are your best practices around documenting member calls?
2. How would you support a member who just received a terminal diagnosis?
3. What is your understanding of the "minimum necessary rule?"
4. Can you share your best practices for protecting PHI and follow HIPAA guidelines?
5. What best practices do you use during a crisis call?
6. How do you help a member when you don't know the answer to their question?
7. Can you tell me what steps you would take for a member who has called several times or spoken to several agents?
8. What are you best practices for members who are difficult to understand?
9. How do you manage extreme change?
10. Tell me about a time you demonstrated extreme empathy with a member?
11. Tell me about a time you disagreed with a policy or rule and how you handled it?
12. What does it mean to take ownership of a call?
13. Can you tell me about a time you didn't provide great customer service? How did you course correct?
14. Have you ever been given feedback you didn't agree with?
15. What is your strongest attribute?
16. Tell me about yourself.
17. Can you tell me about your relevant experience?
18. What do you think are the most important characteristics of a great Customer Service Specialist?
19. Tell me about a time you received excellence customer service?
20. Tell me about a time you anticipated a member's needs?
21. Tell me about a time you dealt with a difficult member and how you handled it?
22. What best practices do you use to portray friendliness over the phone?
23. Tell me about a time you disagreed with your leader and how you navigated that?
24. How do you respond in stressful situations?
25. Name a time you went above and beyond for a member?

Kaiser Permanente Customer Service Specialist Interview Questions

1. What are your best practices around documenting member calls?

2. How would you support a member who just received a terminal diagnosis?

3. What is your understanding of the "minimum necessary rule?"

4. Can you share your best practices for protecting PHI and follow HIPAA guidelines?

5. What best practices do you use during a crisis call?

6. How do you help a member when you don't know the answer to their question?

7. Can you tell me what steps you would take for a member who has called several times or spoken to several agents?

8. What are you best practices for members who are difficult to understand?

9. How do you manage extreme change?

10. Tell me about a time you demonstrated extreme empathy with a member?

11. Tell me about a time you disagreed with a policy or rule and how you handled it?

12. What does it mean to take ownership of a call?

13. Can you tell me about a time you didn't provide great customer service? How did you course correct?

14. Have you ever been given feedback you didn't agree with?

15. What is your strongest attribute?

16. Tell me about yourself.

17. Can you tell me about your relevant experience?

18. What do you think are the most important characteristics of a great Customer Service Specialist?

19. Tell me about a time you received excellence customer service?

20. Tell me about a time you anticipated a member's needs?

21. Tell me about a time you dealt with a difficult member and how you handled it?

22. What best practices do you use to portray friendliness over the phone?

23. Tell me about a time you disagreed with your leader and how you navigated that?

24. How do you respond in stressful situations?

25. Name a time you went above and beyond for a member?