JOB TITLE

Customer Service Representative (Bilingual Required)

Location: Orange, CA

Schedule: Monday through Friday, 9:00 a.m. to 5:30 p.m. with 30 minute lunch

Pay: 23-31/hour

Requirements: 6 months HMO experience, type 35 wpm, high school diploma or equivalent, bilingual Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese

Job Type: 6 month contract

Job Title & Quick Summary:

The Customer Service Representative (CSR) will be the first line of contact for members and providers. The incumbent will assist members and providers with questions related to the program. The incumbent will provide information regarding eligibility, enrollment, benefits and services to eligible members and providers.

Responsibilities:

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


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


• Guides members in understanding and accessing the benefits they are entitled to under Medicare and Medi-Cal, through the OneCare program.


• Address 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.


• Initiates referrals to both internal/external care management departments and other departments, governments or community agencies.


• Participates in departmental phone outreach campaigns on a regular basis.


• Completes other projects and duties as assigned.

Minimum Qualifications:

- High School diploma or equivalent PLUS 6 months of experience in a call center capacity 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.
- Typing speed of 35 words per minute (WPM) required.

Preferred Qualifications:

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

Required Licensure / Certifications: