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Customer Service Representative

Date Posted: 6/13/2024

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Job Description

Duties & Responsibilities:

* 80% - Program Support

* Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.

* Maintains departmental productivity and quality standards.

* Follows through on and completes all member and provider inquiries or requests during the original member and provider interaction.

* Serves as a resource for other team members.

* 15% - Administrative Support

* Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department.

* Addresses member and provider inquiries, questions and concerns in all areas including eligibility, enrollment, claims or authorization status, benefit interpretation and referrals/authorizations for medical care in-person or telephonically.

* Enters accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction.

* Communicates, builds and maintains internal and external relationships by prompt and accurate service delivery.

* Identifies and communicates challenges that might arise with the use of professional judgment while adhering to departmental policies and procedures.

* 5% - Completes other projects and duties as assigned.

Minimum Qualifications:

* High School diploma or equivalent required.

* 6 months of experience in a call center capacity required.

* Typing speed of 35 words per minute (WPM) required.

* An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Preferred Qualifications:

* 6 months of Medi-Cal/Medicaid or health services experience.

Required Licensure / Certifications:

* N/A

Knowledge & Abilities:

* Develop rapport and establish and maintain effective working relationships with

Health's leadership and staff and external contacts at all levels and with diverse backgrounds.

* Work independently and exercise sound judgment.

* Communicate clearly and concisely, both orally and in writing.

* Work a flexible schedule; available to participate in evening and weekend events.

* Organize, be analytical, problem-solve and possess project management skills.

* Work in a fast-paced environment and in an efficient manner.

* Manage multiple projects and identify opportunities for internal and external collaboration.

* Motivate and lead multi-program teams and external committees/coalitions.

* Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

* Ability to visually read information from computer screens, forms and other printed materials and information.

* Ability to speak (enunciate) clearly in conversation and general communication.

* Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.

* Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.

* Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Work Environment:

If located at the 500, 505 Building or a remote work location:

* Work is typically indoors and sedentary and is subject to schedule c
To apply please email your resume to jagonzalez@ultimatestaffing.com

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Job Snapshot

  • Employee Type:Full-Time
  • Location:Orange, CA
  • Job Type:Admin - Clerical
  • Experience:None
  • Education:None
  • Date Posted:6/13/2024
  • Contact: Jackie Gonzalez (424) 376-3229
  • Pay Range: $23.00 - $31.00 Hourly
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Job Reference: JN -062024-369719