Customer Service Representative

3 weeks ago

Fremont, California, United States Info Way Solutions Full time
Job Summary

CalOptima Health is seeking a highly motivated and experienced Customer Service Representative (Non-Bilingual) to join our team. The Customer Service Representative will be the first line of contact for CalOptima Health's members and providers. The incumbent will assist members and providers with questions and/or complaints related to the Medi-Cal programs for Orange County. The incumbent will provide information regarding eligibility, enrollment, benefits, and services to CalOptima Health's eligible members and providers.

Position Information:

  • Department: Customer Service
  • Salary Grade: C - $29.7106
  • Work Arrangement: Full Office

Duties & Responsibilities:

  • 80% - Program Support
  • Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity, and accountability.
  • Maintains departmental productivity and quality standards.
  • Follows through on and completes all member and provider inquiries or requests during the original member and provider interaction.
  • Serves as a resource for other team members.
  • 15% - Administrative Support
  • 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 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.
  • Communicates, builds, and maintains internal and external relationships by prompt and accurate service delivery.
  • Identifies and communicates challenges that might arise with the use of professional judgment while adhering to departmental policies and procedures.
  • 5% - Completes other projects and duties as assigned.

Minimum Qualifications:

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

Preferred Qualifications:

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

Required Licensure / Certifications:

  • N/A

Knowledge & Abilities:

  • Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
  • Work independently and exercise sound judgment.
  • Communicate clearly and concisely, both orally and in writing.
  • Work a flexible schedule; available to participate in evening and weekend events.
  • Organize, be analytical, problem-solve, and possess project management skills.
  • Work in a fast-paced environment and in an efficient manner.
  • Manage multiple projects and identify opportunities for internal and external collaboration.
  • Motivate and lead multi-program teams and external committees/coalitions.
  • Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

  • Ability to visually read information from computer screens, forms, and other printed materials and information.
  • Ability to speak (enunciate) clearly in conversation and general communication.
  • Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
  • Manual dexterity for typing, writing, standing, and reaching, flexibility, body movement for bending, crouching, walking, kneeling, and prolonged sitting.
  • Lifting and moving objects, patients, and/or equipment 10 to 25 pounds

Work Environment:
If located at the 500, 505 Building or a remote work location:

  • Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
  • There are no harmful environmental conditions present for this job.
  • The noise level in this work environment is usually moderate.

About CalOptima Health:
CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity, and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health.

We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring.

CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization.

It is why people choose to work here and why they choose to stay

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives.

Our organization strives to create and maintain a workplace environment that is inclusive, equitable, and welcoming so we can truly be Better Together.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position.

CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws.

CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Apex Talent Solutions LLC Full time

    Customer Service RepresentativeWe are seeking a highly skilled and customer-focused Customer Service Representative to join our team at Apex Talent Solutions LLC.Key Responsibilities:Provide exceptional customer service through various communication channels, including phone, email, and chat.Respond to customer inquiries in a timely and professional manner,...

  • Customer Service Representative

    3 weeks ago

    Fremont, California, United States Citigroup Inc Full time

    The Customer Service Representative is an entry-level position at Citigroup Inc. responsible for delivering high-quality client-facing services and processing transactions in a branch environment. The primary objective is to provide exceptional customer service and contribute to the branch's revenue generation by offering optimal solutions.As the first point...

  • Customer Service Representative

    3 weeks ago

    Fremont, California, United States Aimbridge Hospitality Full time

    Customer Service RepresentativeAimbridge Hospitality is seeking a skilled Customer Service Representative to join our team. As a Front Desk Agent, you will be responsible for:Greeting and welcoming all guests approaching the Front DeskMaintaining proper operation of the telephone switchboardHandling requests for information, mail, and messagesAnswering guest...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Info Way Solutions Full time

    Job Title: Customer Service RepresentativeAt Info Way Solutions, we are seeking a highly skilled and customer-focused Customer Service Representative to join our team. As a key member of our customer service team, you will be responsible for providing exceptional service to our customers via phone and email.Key Responsibilities:Respond to customer inquiries...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Info Way Solutions Full time

    Job SummaryCalOptima Health is seeking a highly motivated and experienced Customer Service Representative to join our team. The Customer Service Representative will be the first point of contact for CalOptima Health's members and providers, assisting with questions and/or complaints related to the Medi-Cal programs for Orange County.Key...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Ultimate Staffing Full time

    Customer Service Representative/Inside Sales OpportunityWe are seeking a highly skilled Customer Service Representative/Inside Sales professional to join our team in Fremont. As a key member of our sales team, you will be responsible for providing exceptional customer service and support to our clients.Key Responsibilities:Interact effectively with customers...

  • Domino's Customer Service Representative

    4 weeks ago

    Fremont, California, United States Domino's Franchise Full time

    Customer Service RepresentativeAs a Customer Service Representative at Domino's, you are the face of our brand. You will be the first point of contact for our customers, providing a fun, happy, and exciting environment while taking orders.Key Responsibilities:Provide exceptional customer serviceTake orders accurately and efficientlyUphold and represent the...

  • Customer Service Representative

    3 weeks ago

    Fremont, California, United States Premier Subaru of Fremont Full time

    Job DescriptionPremier Subaru of Fremont is a successful dealership within the Premier Automotive Group, with over 32 stores across 7 states nationwide. We represent top brands such as Honda, Toyota, Nissan, Kia, Dodge, Chrysler, Jeep, and Fiat. Our company is actively involved in giving back to our community through our "Giving Hope Foundation."We are...

  • Customer Service Representative

    3 weeks ago

    Fremont, California, United States Premier Subaru of Fremont Full time

    Premier Subaru of Fremont is part of a successful and established Premier Automotive Group with over 32 stores in 7 states nationwide. We represent top brands such as Honda, Toyota, Nissan, Kia, Dodge, Chrysler, Jeep, and Fiat. Premier is actively involved in giving back to our community through our Giving Hope Foundation.We are currently seeking a...

  • Customer Service Representative

    3 weeks ago

    Fremont, California, United States Hart Medical Equipment Full time

    Job DescriptionHart Medical Equipment is a premier provider of home medical equipment and supplies. We strive to conduct our patient care operation with the highest standards.Job Summary: We are seeking a highly skilled Customer Service Representative to provide exceptional service as the first point of contact for customers. The ideal candidate will have...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Premier Subaru of Fremont Full time

    About UsPremier Subaru of Fremont is part of a successful Premier Automotive Group with over 32 stores in 7 states nationwide. We represent top brands such as Honda, Toyota, Nissan, Kia, Dodge, Chrysler, Jeep, and Fiat.Job SummaryWe are seeking a Cashier/Customer Service Representative, Part-Time to join our team. As a key member of our team, you will be...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Ninna Chugh - State Farm Agent Full time

    Job DescriptionAt Ninna Chugh - State Farm Agent, we are seeking a highly skilled and empathetic professional to fill the role of Customer Relations Representative. As a customer-oriented expert, you will be responsible for marketing the best Life/Health insurance services and products to benefit clients and their families. Your sales experience will equip...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Premier Subaru of Fremont Full time

    Premier Subaru of Fremont is a leading automotive group with a strong commitment to customer satisfaction. We are seeking a skilled Customer Service Representative to join our team.The ideal candidate will possess excellent communication and problem-solving skills, with the ability to work effectively in a fast-paced environment. Key responsibilities will...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Jabil Full time

    Job Summary:As a Customer Service Administrator at Jabil, you will play a vital role in providing exceptional customer service and support to our clients. This is an exciting opportunity to join a dynamic team and contribute to the success of our organization.Key Responsibilities:Provide timely and accurate information to customers regarding order status and...

  • Customer Service Representative

    3 weeks ago

    Fremont, California, United States LaborMax Staffing Full time

    Job Summary:We are seeking a highly skilled Customer Service Representative to join our team at LaborMax Staffing. As a key member of our sales team, you will be responsible for providing exceptional customer service, processing orders, and resolving customer inquiries in a timely and professional manner.Key Responsibilities:Provide clear and concise product...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Symmetry Financial Group - Gary Uyemura Full time

    Unlock Your Potential with Symmetry Financial Group - Gary UyemuraAre you ready to embark on a career that offers unlimited earning potential and a proven track record of success?At Symmetry Financial Group - Gary Uyemura, we're seeking ambitious individuals to join our team as Customer Service Representatives. As a key member of our team, you'll have the...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States Massage Envy Full time

    Overview:We're seeking a skilled Customer Service Representative to join our team at Massage Envy Spa Fremont. As a key member of our staff, you'll be responsible for delivering exceptional customer experiences and promoting the value of Total Body Care.Key Responsibilities:Provide outstanding customer service and ensure every guest feels valued and...

  • Customer Service Representative

    3 weeks ago

    Fremont, California, United States Massage Envy Full time

    Overview:We're seeking a skilled Customer Service Representative to join our team at Massage Envy Spa Fremont. As a key member of our staff, you'll play a vital role in delivering exceptional customer experiences and promoting our Total Body Care services.Perks and Benefits:Competitive hourly pay plus bonuses and commissionsMatching 401(k) planPaid time off...

  • Customer Service Representative

    4 weeks ago

    Fremont, California, United States CompSpec Inc. Full time

    Job SummaryAs a Customer Service Representative at CompSpec Inc., you will play a vital role in working with the uninsured population to facilitate access to government programs. Your expertise in Medi-Cal and Indigent programs will be highly valued, and you will be responsible for managing a portfolio of third-party eligibility and recovery. If you have a...

  • Customer Service Representative

    2 months ago

    Fremont, California, United States CompSpec Inc. Full time

    Job DescriptionWe are seeking a highly skilled and detail-oriented individual to join our team as a Customer Service Representative. In this role, you will work closely with the uninsured population to assist with Government programs, including Medi-Cal and Indigent programs.Key Responsibilities:Manage a portfolio for third-party eligibility/recoveryWork...