Job Description

Join Our Team as a Patient Services/Call Center Representative!

Are you a compassionate and experienced customer service professional looking to make a real difference in healthcare? We are seeking a dedicated Call Center Customer Service Representative to be the first point of contact for our members, providers, and advocates. If you are a strong communicator, a quick learner, and thrive in a fast-paced environment, we encourage you to apply!

As a vital member of our Patient Services team, you will handle first-level calls and provide essential support, including:

• Answering and resolving a high volume of incoming calls from members, potential members, providers, and advocates.
• Handling core inquiries such as member eligibility verification, general program and administration questions, and benefits and services.
• Providing essential information to members regarding access to care, coordination of care, and benefits.
• Troubleshooting and triaging calls to the appropriate internal units or outside entities to ensure seamless service.
• Ensuring compliance with Health Insurance Portability and Accountability Act ( HIPAA ) regulations at all times.
• Verifying member demographics and confirming insurance information.

Required Education & Experience:

• High School Diploma or High School Equivalency Certificate (equivalent experience accepted per hiring manager).
• At least 6 months of customer service call center experience .
• Data entry experience with the ability to type a minimum of 40 words per minute .
• Knowledge of medical terminology .

Required Skills:

1. Experience handling inbound calls and successfully resolving member/customer issues.
2. Excellent customer service skills with the ability to handle patients with empathy and compassion, particularly those who are disadvantaged, seniors, or people with chronic conditions/disabilities.
3. Ability to answer a high volume of calls in a fast-paced environment.
4. Must be a quick learner with the ability to troubleshoot and redirect calls effectively.
5. A strong team player with excellent attendance, reliability, and punctuality.

Bonus Skills:

• Experience with CalAIM , Enhanced Care Management , or Health Plan operations.
• Bilingual in Spanish is a major plus!

Details

• Schedule: Monday - Friday, 8:00 AM - 5:00 PM
• Location: ONSITE El Segundo, CA 90245

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