Customer Service Representative 2

3 weeks ago


Rancho Cordova, United States Wollborg Michelson Recruiting Full time $20
Job DescriptionJob Description

Call Center Representative 2

Summary:

This position will be in support of inbound calls and resolve member issues related to RX, PCP, Benefits, and Eligibility.

Job Duties:

  • Resolve incoming calls regarding member eligibility, benefits, provider information, monthly premium billing, clinical and pharmacy needs
  • Compose routine and non-routine correspondence to answer benefits/provider inquiries in writing
  • Coordinate membership changes, such as member's primary care physician
  • Perform routine to mid-level inventory reduction, including member inquiries, claim adjustments, and email responses
  • Review and analyze member claims for accuracy and provide member education on how benefits are applied
  • Participate in quality and efficiency workgroups to improve member/customer satisfaction
  • Analyze available programs, determine program eligibility, and connect members to appropriate vendors, Health Advocates, Social Workers, Pharmacy Techs, and Pharmacists
  • Verify member inclusion or targeting in outreach or care gap programs and connect members to programs or services when appropriate
  • Engage members with their wellness plan options
  • Resolve pharmacy calls regarding benefits coverage, co-pays, formulary coverage, vacation overrides, and utilization management requirements
  • Provide prescription-related benefit coverage information, including co-pays, formulary coverage, and utilization management requirements
  • Provide deductible and max out of pocket information
  • Provide status of prior authorization requests
  • Assist members in understanding when and how to appeal a coverage decision
  • Perform other assigned duties

Skills/Qualifications:

  • Requires at least 2 years of prior relevant experience (e.g. Customer Service), preferably Healthcare Experience
  • Requires basic job knowledge of Microsoft Suite systems and proficiency in computer applications
  • Background in Armed forces preferred
  • Call Center Experience preferred

Education Requirements:

Minimum High School Diploma

Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one’s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one’s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.

 

 

 

#LI-JH2



  • Rancho Cordova, California, United States Jones Lange Lasalle, Inc. Full time

    Job Summary:The Customer Service Representative will be responsible for delivering exceptional client and guest experiences by ensuring that all customers and visitors are assisted in a welcoming, professional, and friendly manner. This client-facing role provides a unique opportunity to work in a fast-paced environment, providing Receptionist, Operations,...


  • Rancho Cordova, United States Atlas Disposal LLC Full time

    Position Summary The Customer Service Representatives will serve Atlas Disposal customers by providing information and resolution of product and service-related topics over the phone, by email, and through text messaging. CSRs will work closely with other departments to resolve product or service needs. Work Environment and Expectations This is a...


  • Rancho Cordova, United States Pacific Office Automation Full time

    We are looking to hire an Customer Service Representative at our office in Sacramento, CA If you have a passion for customer service, are organized, and love working in a team player environment, we want to hear from you! Essential Job Duties Source Customer Service Representative, Customer Service, Representative, Manufacturing, Retail


  • Rancho Cordova, United States U-Haul Full time

    Compensation Range: $16.00 to $25.00 Hourly Location: 11351 Pyrites Wy, Rancho Cordova, California 95670 United States of America Are you a people person? Do you love helping others? U-Haul is in search of friendly, motivated people for the position of Customer Service Representative. As a Customer Service Representative, you will work as part of a...


  • Rancho Cordova, United States MMC Group Full time

    **Job Details** **Call Center** Customer Service Representative Rancho Cordova, CA Posted: 2/28/2022 Job Description Job ID#: 52582 Job Category: Call Center Position Type: *W2 Positions Available: 8 Throughout the past 25 years plus, MMC, one of the most trusted names in workforce management services, has successfully delivered strategic solutions to large...


  • Rancho Cordova, California, United States Tanklessproaz Full time

    Job Description**Job Summary:**Tanklessproaz is seeking a highly skilled and experienced Customer Service Representative to join our team as a Service Dispatcher. As a key member of our operations team, you will be responsible for providing exceptional customer service, scheduling and dispatching service technicians, and ensuring seamless communication with...


  • Rancho Cordova, California, United States SAFE Credit Union Full time

    About the RoleWe are seeking a highly skilled and customer-focused individual to join our Contact Center team as a Customer Service Representative. As a key member of our team, you will be responsible for providing exceptional service to our members, resolving their inquiries and concerns in a prompt and professional manner.Key ResponsibilitiesProcess member...


  • Rancho Cordova, California, United States Great Day Improvements: A Family of Brands Full time

    Job Summary:We are seeking a highly motivated and customer-focused Customer Service Representative to join our team at Great Day Improvements: A Family of Brands. As a key member of our customer service team, you will be responsible for providing exceptional customer experiences through inbound and outbound calls, emails, and other communication channels.Key...


  • Rancho Cordova, California, United States Great Day Improvements: A Family of Brands Full time

    Job Summary:We are seeking a highly motivated and customer-focused Customer Service Representative to join our team at Great Day Improvements: A Family of Brands. As a key member of our customer service team, you will be responsible for providing exceptional customer experiences through inbound and outbound calls, emails, and other communication channels.Key...


  • Rancho Cordova, United States ACERTUS Full time

    ACERTUS is growing and looking to add Customer Service reps to our Repossession team. ACERTUS is the only tech-enabled automotive logistics company to move, store, recondition, title & register finished vehicles. As a Customer Service Representative, you will serve as a point of contact in maintaining vendor relationships, including assignment follow up,...


  • Rancho Cordova, California, United States TJX Companies Full time

    Position Overview:The Tactical Uniform Customer Service Representative is a dedicated professional who plays a crucial role in enhancing customer interactions at the forefront of our retail environment.Key Responsibilities:This representative is responsible for delivering exceptional customer service, ensuring that each customer feels valued and engaged....


  • Rancho Cordova, United States Atlas Disposal Industries Full time

    General Nature of Position: Serves customers by providing product and service information; resolving product and service problems. Essential Duties and Responsibilities: Handle commercial, residential, and roll-off customer calls for new accounts, changes in service, billing questions, service cancellations, misses, etc. Complete appropriate forms and...


  • Rancho Cordova, United States Clark Pest Control Full time

    ** Administrative Customer Service Representative** **Job Category****:** Administrative **Supervisor****:** Justine Sells **Requisition Number****:** ADMIN023649 Showing 1 location **Job Details** **Description** Since 1950, Clark Pest Control has made the lives of people throughout California and now northwestern Nevada pest-free, worry-free! We'd love to...


  • Rancho Cordova, United States Pacific Office Automation Full time

    Job DescriptionJob DescriptionPacific Office Automation is the largest independently-owned document imaging and technology dealers in the nation. Since 1976, we have grown to over thirty branches located in ten western states: OR, WA, CA, AZ, NM, NV, UT, ID, CO, & TX. With over 40 years of success in office equipment and technology sales/service, our growth...


  • Rancho Cordova, United States Amerifleet Transportation, Inc. Full time

    Job DescriptionJob DescriptionACERTUS is growing and looking to add Customer Service reps to our Repossession team. ACERTUS is the only tech-enabled automotive logistics company to move, store, recondition, title & register finished vehicles. As a Customer Service Representative, you will serve as a point of contact in maintaining vendor relationships,...

  • Customer Service

    4 weeks ago


    Rancho Cordova, United States Manpower Full time

    Our client, is seeking a Bilingual Customer Service Representative to join their team. The ideal candidate will be bilingual in either Loatian/Lao, Japanese, Mandarin, Cantonese, Vietnamese, Korean, Cambodian, Hmong Tagalog, and Spanish and have Clerical Customer Service experience.   Job Title: Bilingual Customer Service Representative Location: CA ,...


  • Rancho Cordova, California, United States Marshalls Full time

    Position Overview:As a Customer Service Representative at Marshalls, you will play a vital role in enhancing the shopping experience for our valued customers. Your responsibilities will include:Exemplifying Customer Engagement: Demonstrate established practices for delivering exceptional customer service to both internal and external clients.Fostering a...


  • Rancho Cordova, California, United States Magellan Health Full time

    Job SummaryMagellan Health is seeking a highly skilled Customer Care Supervisor to lead our customer service team. As a key member of our organization, you will be responsible for supervising a team of customer care representatives, ensuring excellent customer service, and driving business growth.Key ResponsibilitiesSupervise a team of customer care...


  • Rancho Cordova, California, United States SAFE Credit Union Full time

    Opportunity for hybrid or remote work arrangements.Hourly Compensation: $22.55 Actual pay may differ based on qualifications, experience, and geographic location. Why Choose SAFE? SAFE provides more than just comprehensive medical, vision, dental, 401k matching, HSA, and FSA benefits. Discover how we prioritize our employees through: Professional...


  • Cordova, Tennessee, United States The Auto Club Group Full time

    About The Auto Club GroupThe Auto Club Group is a leading provider of membership, travel, insurance, and financial services to over 14 million members across 14 states and 2 U.S. territories.Job SummaryWe are seeking a highly motivated and customer-focused Branch Customer Service Representative to join our team. As a key member of our branch team, you will...