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Partnership HealthPlan of California

Member Services Representative

Career Insights for Customer Service Representative (General)

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What they do

A Customer Service Representative interacts directly with customers to answer questions and solve problems. Communicates with customers in person, over the phone or online. Provides help with troubleshooting technical problems for equipment or software. Keeps records of customer communications and transactions.

$42,494 / year median in California

-9% projected decline

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Job Description

Member Services Representative Partnership HealthPlan of California - 3.2 Fairfield, CA Job Details Full-time $28.52 - $33.51 an hour 16 hours ago Qualifications Spanish Insurance products customer support Phone communication Client inquiry handling Health insurance customer support De-escalation techniques Conflict de-escalation Incident Escalation Insurance issue resolution High school diploma or GED Russian Data entry Tagalog Telecommunications headsets Typing 1 year Cross-functional collaboration Escalation handling Communication skills Entry level Client interaction via phone calls
Full Job Description Overview:
To respond to member and provider issues and inquiries. Ensures that callers' questions and/or problems are resolved or are directed to the appropriate person for resolution and provides the highest level of customer service.
Responsibilities:
Responds to member and provider issues and questions received in the member services queue. Documents calls as appropriate. Escalates calls to Lead Member Services Representative or Member Services management, as needed. Works with internal departments, providers, and external organizations to resolve issues as needed. Reviews all incoming e-mails to ensure compliance with instructions that impact processes and/or benefits that impact members. Processes enrollment duties as assigned. Enters data in relevant online systems. Other duties as assigned.
Qualifications:
Education and Experience High school diploma or equivalent; minimum one (1) year Call Center experience in a MCO setting and/or working with the public in a service environment, preferred; previous customer service or call center experience preferred. Special Skills, Licenses and Certifications Excellent verbal and written communication skills, ability to relate and connect with callers, good phone voice, patience, good problem resolution skills and the ability to show empathy when appropriate. Enjoys assisting callers and working with the public in sometimes stressful situations. Ability to de-escalate angry callers. Bilingual skills in Spanish, Tagalog, or Russian are preferred. Performance Based Competencies Typing 25 wpm. Work Environment And Physical Demands More than 50% of work time is spent using a headset, keyboard and multiple computer monitors. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan's policies and procedures, as they may from time to time be updated.
HIRING RANGE
$28.52 - $33.51 IMPORTANT
DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Benefits

  • Health Insurance
  • Dental Insurance