Find & Apply For Customer Service Representative Jobs in Modesto, California

Customer Service Representative AllCare IPA | Customer Service Department AllCare Medical Group Full-Time |

In-Person Pay:

Starting at $21 to $22 per hour, based on experience About the Position AllCare IPA is seeking a dependable and customer-focused Customer Service Representative to join our team. This position serves as a primary point of contact for members, healthcare providers, health plans, and internal departments. The ideal candidate is professional, organized, and comfortable working in a fast-paced healthcare environment. You will assist with questions regarding provider networks, referrals, authorizations, claims, eligibility, and access to care while helping ensure issues are resolved accurately and timely. Responsibilities Answer incoming calls and assist members, providers, and health plan representatives in a professional and courteous manner. Assist members with questions regarding provider networks, referrals, authorizations, eligibility, and access to care. Provide claims status information and assist with claim-related inquiries. Research and resolve member and provider questions and concerns. Accurately document calls and other interactions in company systems. Work closely with Utilization Management, Claims, Finance, and Provider Relations to resolve issues. Escalate complex concerns to the appropriate department or leadership when necessary. Educate members regarding healthcare services and available resources. Meet departmental standards for productivity, quality, accuracy, and customer service. Maintain confidentiality and follow HIPAA requirements and company policies. Participate in training and maintain current knowledge of health plan requirements, benefits, and procedures. Qualifications High school diploma or equivalent required. Associate degree preferred. Minimum of 1 years' experience of customer service is required. Healthcare, managed care, medical insurance, IPA, medical group, or health plan experience preferred. Bilingual English/Spanish is a plus. Skills We're Looking Fo r Excellent customer service and communication skills. Strong problem-solving skills and attention to detail. Ability to remain professional when handling difficult or sensitive situations. Ability to multitask and prioritize in a fast-paced environment. Basic understanding of referrals, authorizations, claims, and eligibility is preferred. Comfortable using Microsoft Office and healthcare management systems. Ability to work independently as well as part of a team. Dependable, organized, and able to communicate effectively with members, providers, coworkers, and health plans. Work Environment This is an office-based position that requires frequent telephone and computer use. The position involves regular interaction with members, healthcare providers, health plans, and internal departments. Benefits 401(k) with company match, fully vested Medical, dental, and vision insurance Generous vacation time Paid holidays Equal Employment Opportunity AllCare IPA is committed to providing equal employment opportunities and maintaining a diverse and inclusive workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, national origin, veteran status, or any other status protected by applicable law. Please send a resume to jobs@allcareipa.com or AllCare, 3320 Tully Road Modesto, CA 95350

Attn:

Human Resources.

Pay:

$21.00 - $22.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person