Onsite Call Center Location:

Alameda, CA 94502 (Onsite)

Schedule:

Monday-Friday, 8:00 AM-5:00

PM Pay:

$28.61/hr Summary Hiring a Member Services Representative to support members and providers in a fast-paced, high-volume call center environment. As a Member Services Representative , you will be the first point of contact for routine and complex service needs—answering inbound calls and responding to email/chat/fax inquiries, researching issues across multiple systems, and documenting every interaction in a CRM. This Member Services Representative role is ideal for a bilingual customer service professional who can explain benefits, eligibility, claims, authorizations, and health plan services clearly and professionally. Responsibilities Answer a high volume of inbound/outbound calls and handle member inquiries via phone, email, chat, fax, and written correspondence Provide accurate information on health plan benefits, eligibility, claims, authorizations, pharmacy/PBM-related questions, and service guidelines De-escalate dissatisfied callers and drive first-call resolution when possible; set follow-ups appropriately when needed Document all contacts clearly and consistently in a CRM (service requests, dispositions, notes, and outcomes) Research member issues across multiple databases/screens (multi-monitor setup) and collaborate with internal departments to resolve complex cases Support compliance with regulatory guidelines and plan policies (including

DMHC/DHCS

expectations) Assist members with online self-service tools such as member portals and web resources Maintain confidentiality and meet quality, productivity, attendance, and customer satisfaction metrics Qualifications High school diploma or GED required (Bachelor's degree preferred or equivalent experience) Bilingual Tagalog/English required ; must pass a bilingual proficiency exam (90%+ score) 1+ year of direct customer service experience (call center experience preferred; managed care/health plan experience is a plus) Experience determining eligibility for financial assistance, insurance benefits, unemployment, and/or social services programs preferred Comfortable using a headset, working on computers all day, and navigating multiple systems/windows Strong communication, active listening, and accurate documentation skills Familiarity with medical terminology and healthcare/member services workflows is a plus

INDRS Pay:

$28.61 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Health savings account Life insurance Vision insurance

Work Location:

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