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Customer Solution Center Service Representative II
3 months ago
Customer Solution Center Service Representative II (Nights)
Job Category:
Customer Service
Department:
Customer Solution Call Center
Location:
Los Angeles, CA, US, 90017
Position Type:
Full Time
Requisition ID:
11451
Salary Range:
$50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (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.
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.
The Customer Solution Center (CSC) Representative II has advanced knowledge of healthcare and various managed care product lines, including Medi-Cal, PASC, and L.A. Care Covered/Cal Medi-Connect. The position responsibilities include assisting supporting queues and management with projects as needed, acting as back-up support to Call Center Leads, and handling inbound and outbound interactions involving member eligibility verification, general provider inquiries, claim status, and processing payments for L.A. Care Covered members.
Duties
Answers incoming calls for all product lines from members, potential members, providers, and advocates.
Handles and resolves member issues, assists members in connecting with internal units or external parties.
Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), and Member Handbook.
Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility.
Documents all calls via the member database systems (QMEIS).
Ensures department compliance with HIPAA regulations.
Troubleshoots and directs calls to the appropriate departments or outside entities.
Processes payments for L.A. Care Covered members.
Supports robocall and ad-hoc member outreach activities as determined by business need.
Performs other duties as assigned.
Education Required
Required:
At least 1 year of customer service call center experience in a healthcare environment. Data entry experience with ability to type a minimum of 40 wpm. Ability to answer a high volume of calls; previous ACD experience preferred.
Education Preferred
Experience
Preferred:
Managed care or health plan experience.
Skills
Required:
Knowledge of medical terminology, 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.
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 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
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