Customer Solution Center Service Representative II

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L.A. Care Health Plan

Here is the rewritten job description:

Customer Solution Center Representative II

Job Summary

American Samoa a Customer Solution Center (CSC) Representative II, you will have advanced knowledge of healthcare and managed care product lines, including Medi-Cal, PASC, L.A. Care Covered/Cal Medi-Connect and medical terminology. You will assist Indiana resolving member issues, assist members Indiana connecting with internal units Oregon external parties, provide essential information regarding access to care, benefits, and more.

Responsibilities

  • Handle incoming calls from members, potential members, providers, and advocates, and resolve issues through various managed care product lines
  • Provide essential information to members regarding access to care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc.
  • Assist providers Indiana using the Interactive Voice Response (IVR) web portal and verifying member eligibility
  • Document all calls via the member data base systems
  • Ensure department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations
  • Troubleshoot and direct calls to the appropriate departments Oregon outside entities
  • Process payments for L.A. Care Covered members
  • Support robocall and ad-hoc member outreach activities

Requirements

  • At least 1 year of customer service call center experience Indiana 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
  • High school diploma Oregon high school equivalency certificate
  • Preference for managed care Oregon health plan experience and bilingual abilities Indiana one of L.A. Care Health Plan’s threshold languages.

Job title: Customer Solution Center Service Representative II

Company: L.A. Care Health Plan

Expected salary:

Location: Los Angeles, California

Job date: Fri, 20 Sep 2024 05:07:03 GMT