Back to Jobs search

Customer Solution Center Service Representative I

L.A. Care Health Plan • Los Angeles, CA • 1d ago

Job Category: Customer Service

Department: Customer Solution Call Center

Location:

Los Angeles, CA, US, 90017

Position Type: Full Time

Requisition ID: 12892

Salary Range: $45,760.00 (Min.) - $47,823.00 (Mid.) - $55,818.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Customer Solution Center Service Representative I is responsible for a successful completion of the Member Services training program and continues to gain strong knowledge of Medi-Cal and Personal Assistance Services Council (PASC) managed care product lines.

The Customer Solution Center Service Representative I handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, member requests for I.D. cards and Primary Care Provider (PCP) changes, and triage of calls to appropriate units or outside entities.

Duties

Answers incoming first level calls from members, potential members, providers and advocates. Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc. Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc. Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility. Documents all calls via the member data base system, QMEIS.

Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information. Troubleshoots and directs calls to the appropriate departments or outside entities. (75%)

Supports robocall and ad-hoc member outreach activities as determined by business need. (15%)

Perform other duties as assigned. (10%)

Duties Continued

Education Required

High School Diploma/or High School Equivalency Certificate

Education Preferred

Experience

Required:

At least 6 months of customer service call center experience.

Data entry experience with ability to @type a minimum of 40 words per minute.

Preferred:

Managed care or health plan experience.

Skills

Required:

Ability to answer a high volume of calls.

Knowledge of medical terminology.

Must be a strong team player, punctual, and has excellent attendance record.

Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities.

Must be a quick learner, excellent team player and customer service oriented.

Preferred:

Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Light

Additional Information

L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include, but not be limited to, evenings, weekends and holidays.

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

L.A. Care offers a wide range of benefits including

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Volunteer Time Off (VTO)

Similar Jobs

Logistics Management Specialist

U.S. Army Reserve Command • Los Angeles, CA • 5h ago

Management & Administrative

Summary About the Position: This is a Military Technician position with the 79th Sustainment Support Command, 420th Transportation Battalion, 304th Sustainment Brigade, 311th Expeditionary Support Command, located in She...

5h ago

Go to Apply

Administrative Assistant

Thrivent Financial • Lakewood, CA • 9h ago

Management & Administrative

Summary This position provides administrative support to Aegis Wealth Advisors. This role is critical to our member experience and requires a friendly, upbeat demeanor. The incumbent supports the daily operations of the...

9h ago

Go to Apply

Franchise Management & Marketing Associate

Warner Bros. Discovery • Burbank, CA • 9h ago

Management & Administrative

Welcome to Warner Bros. Discovery... the stuff dreams are made of. Who We Are... When we say, "the stuff dreams are made of," we're not just referring to the world of wizards, dragons and superheroes, or even to the wond...

9h ago

Go to Apply

ADMINISTRATIVE INTERN (NON-CAREER) - PROGRAM MANAGEMENT

City of Long Beach • Long Beach, CA • 9h ago

Management & Administrative

ADMINISTRATIVE INTERN (NON-CAREER) - PROGRAM MANAGEMENT Print ( https://www.governmentjobs.com/careers/longbeach/jobs/newprint/5201938 ) Apply ? ADMINISTRATIVE INTERN (NON-CAREER) - PROGRAM MANAGEMENT Salary $25.08 Hourl...

9h ago

Go to Apply

Regional Marketing Manager

Harbor Group Management • Los Angeles, CA • 9h ago

Management & Administrative

Harbor Group Management Company is a multi-billion dollar real estate investment and property management firm. As we continue to grow, we are looking for passionate, goal oriented, creative individuals with an entreprene...

9h ago

Go to Apply

Manager, Software Engineering

Snap Inc. • Los Angeles, CA • 17h ago

Management & Administrative

Snap Inc ( https://www.snap.com/en-US/ ) is a technology company. We believe the camera presents the greatest opportunity to improve the way people live and communicate. Snap contributes to human progress by empowering p...

17h ago

Go to Apply

Google Customer Engagement Suite Contact Center as a Service Specialist

Accenture • Los Angeles, CA • 22h ago

Management & Administrative

We Are Accenture is a premier Google Cloud partner helping organizations modernize data ecosystems, build real-time analytics capabilities, and responsibly scale AI. As part of Accenture Cloud First and the Accenture Goo...

22h ago

Go to Apply