Description: Our client is currently seeking a Customer Service Rep. Sr. in Orange, CA!
Overview:
The Customer Service Representative Sr is the first line of contact for members and providers and will assist them with questions related to the Medi-Cal programs for Orange County. The incumbent resolves member inquiries and complaints fairly and effectively. The incumbent provides information regarding eligibility, enrollment, benefits and services to company members and providers.
Responsibilities:
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 inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care.
Verifies member eligibility, claim and authorization status for providers.
Responsible for thorough follow-up and completion of all member and provider inquires or requests.
Responsible for accurate, complete, and correct documentation into Facets regarding all issues, inquires, complaints and grievances.
Functions efficiently and productively in a high-volume call center.
Provides follow-up assistance as needed.
Routes escalated calls to the appropriate Member Liaison Specialist, Supervisor or Call Center Manager.
Processes all member transportation request within one business day of receipt and coordinating all aspects of the process with the clinic, provider, and member as appropriate or necessary.
Assists members with Member Web Portal registration and technical support. Interacts face-to-face with members by assisting with front desk coverage.
Serves as a backup for Customer Service Leads, as needed.
Qualifications & Requirements:
High School diploma or equivalent
2 years of experience in a customer/member service or call center capacity
An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.
Bilingual in English and in one of the following languages (Arabic, Farsi, Chinese, Korean, Spanish, Vietnamese)
2 years of Health Maintenance Organization (HMO), Medi-Cal/Medicaid and health services experience- preferred.
If you or anyone you know is interested please send an updated resume to edavis01@judge.com
Contact: edavis01@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
