Member Support Representative I

2 weeks ago

Alameda, California, United States Alamedaalliance Full time
Overview


The Customer Care Specialist I serves as the initial point of contact for our members, addressing both routine and intricate inquiries with the objective of providing exceptional service.

This role involves managing a substantial volume of incoming and outgoing communications promptly. It is essential to respond to all member inquiries via various channels including email, fax, letters, chat, and phone calls in a timely manner. Prioritizing and adapting to the workload as new requests arise is crucial. The specialist must assess the caller's needs, clarify details, investigate issues, and offer solutions or alternatives whenever feasible. All interactions must be accurately documented in the electronic database.

Role Responsibilities

The Customer Care Specialist I is expected to operate at a foundational level while having the potential to advance to more complex roles such as Customer Care Specialist II or III. Under the guidance of a Supervisor, Manager, and Director, this position plays a vital role in connecting members with our call center and collaborating with other departments to address member concerns.

Key Duties

1. Act as the primary liaison for members, providers, and other stakeholders regarding inquiries related to claims, benefits, authorizations, and eligibility.

2. Address and resolve member service inquiries by identifying the nature of assistance required, including benefits, eligibility, claims, and care coordination.

3. Provide timely responses to incoming communications while ensuring high-quality customer service.

4. Recognize and differentiate between issues that require immediate resolution and those needing follow-up.

5. De-escalate situations involving dissatisfied members and provide necessary support.

6. Maintain accurate records of all contacts in accordance with departmental standards.

7. Collaborate with various internal departments to enhance service delivery.

8. Educate members on managed care topics and assist them in utilizing available online resources.

9. Ensure compliance with regulatory requirements and organizational policies.

Qualifications

1. High school diploma or GED required; a bachelor's degree or equivalent experience preferred.

2. Bilingual proficiency in designated languages is required.

3. At least one year of direct customer service experience, preferably in a call center or managed care environment.

4. Proven ability to meet performance metrics and maintain high-quality service standards.

5. Strong problem-solving skills and the ability to adapt to changing situations.

6. Excellent communication skills, both verbal and written.

7. Proficiency in data entry and familiarity with CRM systems.

Work Environment

This position requires the ability to work collaboratively within a team and maintain professionalism at all times. The role involves frequent use of computers and telecommunication devices, and the ability to manage multiple tasks efficiently.

Alameda Alliance is committed to equal opportunity employment and values diversity in the workplace.

  • Member Support Specialist I

    2 weeks ago

    Alameda, California, United States Alamedaalliance Full time

    OverviewAs a Member Services Representative I, you will serve as the initial point of contact for our members, addressing both routine and intricate inquiries with the aim of providing exceptional customer support. Key ResponsibilitiesYour primary duties will include managing a significant volume of inbound and outbound communications promptly. You will...

  • Customer Service Representative

    1 day ago

    Alameda, California, United States Firehouse Subs Full time

    Job SummaryWe are seeking a highly motivated and customer-focused individual to join our team as a Customer Service Representative. As a key member of our front-of-house team, you will be responsible for providing exceptional service to our guests, ensuring a positive dining experience, and contributing to the overall success of our restaurant.Key...

  • Retail Merchandising Representative

    5 days ago

    Alameda, California, United States FRITO LAY Full time

    About the Role:The Merchandiser role at Frito Lay is a dynamic opportunity for a motivated individual to join our team as a Product Display Coordinator. As a key member of our retail merchandising team, you will be responsible for merchandising Frito Lay's complete line of products in stores, including supermarkets and large grocery stores.Key...

  • Security Guard I

    2 weeks ago

    Alameda, California, United States Penumbra Full time

    Job OverviewUnder the direct oversight of management, the Security Guard I plays a crucial role in ensuring the overall safety and security of the facilities and the surrounding grounds of the Company.The security personnel are expected to meticulously document and report any irregularities or unusual occurrences consistently.Work ScheduleThis position...

  • Field Support Specialist

    5 days ago

    Alameda, California, United States Goldbelt Full time

    Job SummaryGoldbelt is seeking a highly skilled Field Support Representative to provide technical support services for the United States Coast Guard (USCG). The ideal candidate will possess expert knowledge of electronic systems and troubleshooting skills.Key ResponsibilitiesProvide on-site support for Electronic and Information Technology systems installed...

  • Supervisor of Student Support Services

    5 days ago

    Alameda, California, United States Alameda Unified School District Full time

    About the RoleThe Alameda Unified School District is committed to upholding our community's core values of equity and excellence for every student by providing inclusive and safe conditions for learning that challenge and support every student to be culturally competent and prepared for college, career, and community participation.Our vision is that each and...

  • Customer Service Representative for Plumbing Company

    2 days ago

    Alameda, California, United States Big Blue Plumbing Full time

    Job OverviewWe are seeking a highly skilled and customer-focused individual to join our team as a Customer Care Representative for our plumbing company.Key Responsibilities:Provide exceptional customer service and support to clients via phone and in-personBook and schedule appointments for plumbing services, ensuring timely and efficient deliveryTrack close...

  • Educational Support Specialist

    2 weeks ago

    Alameda, California, United States Community Learning Center Schools Full time

    About the Organization Community Learning Center Schools (CLCS) is a non-profit entity dedicated to the management and support of two of the Bay Area's most esteemed public charter institutions.CLCS oversees staffing for the following educational establishments:Alameda Community Learning Center | "Nurturing Future Leaders" | Nea Community Learning Center |...

  • Educational Support Specialist

    2 weeks ago

    Alameda, California, United States Community Learning Center Schools Full time

    About Community Learning Center Schools (CLCS)Community Learning Center Schools (CLCS) is a non-profit entity dedicated to the support and management of two of the Bay Area's most innovative and esteemed public charter schools.Our SchoolsCLCS oversees the hiring for the following two educational institutions, both situated in Alameda, CA: - Alameda Community...

  • Special Education Teacher

    5 days ago

    Alameda, California, United States Alameda Unified School District Full time

    About the EmployerThe Alameda Unified School District is committed to upholding our community's core values of equity and excellence for every student by providing inclusive and safe conditions for learning that challenge and support every student to be culturally competent and prepared for college, career, and community participation.Our vision is that each...

  • Technical Support Engineer II

    2 weeks ago

    Alameda, California, United States GSPANN Technologies, Inc Full time

    About GSPANN Technologies, IncBased in California, GSPANN Technologies, Inc specializes in providing consulting and IT solutions to clients worldwide. Our mission is to assist organizations in enhancing their operational effectiveness by optimizing their IT capabilities and practices across various sectors, including retail, high-tech, and manufacturing....

  • Special Education Teacher

    1 day ago

    Alameda, California, United States Alameda Unified School District Full time

    About the EmployerThe Alameda Unified School District is committed to upholding our community's core values of equity and excellence for every student by providing inclusive and safe conditions for learning that challenge and support every student to be culturally competent and prepared for college, career, and community participation.Our VisionOur vision is...

  • Bilingual Community Support Specialist

    1 week ago

    Alameda, California, United States A Bright Future, Inc. Full time

    Job OverviewCompany Background:A Bright Future, Inc. is dedicated to providing exceptional services to both our clients and employees. We emphasize respect and foster an environment where all individuals can thrive. Our commitment to leadership and training ensures that our team members have the tools they need for personal and professional development. We...

  • Follow-Up Representative

    3 days ago

    Alameda, California, United States Boost Healthcare Full time

    Job DescriptionCompany OverviewBoost Healthcare is a leading consulting firm specializing in revenue recovery for healthcare providers. Our team of experts works closely with clients to identify and recover denied and underpaid claims from commercial and government payers.Job SummaryThis position is responsible for following up on claim status, denials, and...

  • Retail Sales Representative

    2 weeks ago

    Alameda, California, United States Salvation Army Full time

    Pay Rate: $15.52 Hourly**About The Organization**The Salvation Army (TSA) Adult Rehabilitation Center (ARC) is dedicated to assisting individuals in successfully completing our rehabilitation initiatives. Our organization deeply appreciates the committed efforts of our staff, which are vital for the success and sustainability of our programs.**About The...

  • Customer Service Representative

    5 days ago

    Alameda, California, United States Abbott Laboratories company Full time

    At Abbott Laboratories, you can do meaningful work that makes a difference, grow and develop your skills, take care of yourself and your loved ones, and live a full and balanced life.You'll also have access to:Career development opportunities with a global company where you can grow and advance in roles such as Customer Service, Customer Experience, Service...

  • Licensed School Therapist

    2 days ago

    Alameda, California, United States Spectrum Center Schools and Programs Full time

    About the RoleSpectrum Center Schools and Programs is seeking a highly skilled and dedicated Licensed School Therapist to join our team. As a key member of our staff, you will play a vital role in providing academic and behavioral support to students with emotional and social challenges.Key ResponsibilitiesProvide individual and group counseling sessions to...

  • Sales Associate

    5 days ago

    Alameda, California, United States Salvation Army Full time

    About Our Retail TeamBecome part of a dedicated team at The Salvation Army, working together to serve and impact our local community. Our Main Alameda Thrift Store supports the Adult Rehabilitation Program, providing a unique opportunity to promote a positive shopping/donor experience, enhance customer service, problem-solving and teamwork skills, while...

  • Retail Sales Representative

    2 weeks ago

    Alameda, California, United States Salvation Army Full time

    Pay Rate: $15.52 Hourly**About The Organization**The Salvation Army (TSA) Adult Rehabilitation Center (ARC) is dedicated to aiding individuals in successfully completing our rehabilitation initiatives. Our organization places a high value on the committed contributions of our staff, which are vital for the effectiveness and sustainability of our...

  • Customer Service Associate

    56 minutes ago

    Alameda, California, United States Abbott Laboratories company Full time

    About Abbott LaboratoriesAbbott Laboratories is a leading global healthcare company that provides innovative solutions to improve people's lives. With a rich history of innovation and a commitment to excellence, we strive to make a meaningful difference in the lives of our customers and employees.Job SummaryWe are seeking a highly skilled and experienced...