Location:

Monterey, CA\n

Req ID:

2026-875\n

Job Description:

\nPurpose of Position\nThe Customer Service Representative I is the friendly, knowledgeable front line for our local Medicare Advantage health plan members and healthcare partners. In this role, you'll handle inbound calls and inquiries related to eligibility, benefits, and claims—while serving as a trusted advocate for the people who live, work, and age in the same communities we do.\nOur members aren't just voices on the phone—they're our neighbors, friends, and family members. That's why this role is so critical. We're looking for someone who genuinely enjoys helping people of all ages, brings patience and empathy to every conversation, and takes pride in delivering support that feels personal, respectful, and meaningful. We're looking for naturally curious, solution-oriented problem solvers who can balance compassion with professionalism in a fast-paced environment.\nResponsibilities\nServe as a primary point of contact for members, providers, and clients via phone, email, and occasional in‑person interactions\nAssist with questions related to eligibility, benefits, claims status, prior authorization requirements, and appeals\nProvide accurate, timely, and compassionate responses to all customer inquiries\nProactively educate members and providers based on their specific needs and inquiries, helping them better understand available benefits and next steps\nThoroughly document all communications and actions in the appropriate system of record\nResearch issues and work diligently to bring each inquiry to resolution within established timeframes\nCoordinate member appeals and grievances in collaboration with appropriate internal teams\nProvide support and coverage for interdepartmental staff as needed to ensure continuity of service\nPerform other duties and responsibilities as assigned\nPosition Requirements\nExcellent verbal and written communication skills, including active listening.\nMinimum three years' experience in customer service, call center, or similar.\nService-oriented; Ability to resolve customer complaints and issues while maintaining a professional and calm demeanor.\nAbility to operate spreadsheet, word processing programs and computer equipment required to fulfill position responsibilities.\nExceptional diplomacy skills to effectively resolve issues under sometimes tense and stressful circumstances.\nExcellent phone manner\nAbility to use sound judgement, identify next steps to be taken, and develop appropriate solutions.\nEnglish and Bilingual Spanish/English desired.\nCompetencies\n

Accountability and Dependability:

Assumes responsibility for accomplishing duties in an effective and timely manner.\n

Integrity:

Consistently honors commitments and takes responsibility for actions and words.\n

Software and Computer Skills:

Proficient in the use of Microsoft Office Suite, skilled at using the Internet. Type by touch. Must learns effectively with computer-based and/or online training.\n

Flexibility:

Demonstrates adaptability and openness to alternative solutions and flexibility when interacting with others, understanding their attitudes, needs, interests, and perspectives.\n

Inclusiveness:

The ability to network and partner with all internal and external stakeholders including broad and diverse representation of private/public and traditional/non-traditional community organizations.\nSkills and Education\nAssociates degree, or applicable professional experience, required.\nMinimum 1 to 3 years experience in a customer service, hospitality, or call center.\nBenefits Competitive benefit package\nSalary Commensurate with experience $21.00 - $23.00\nShift differential paid for evening and weekend hours\nEqual Opportunity Employer\n

Assigned Work Hours:

\nVarious schedules. May include evenings (to 8pm) and weekends.\n

Position Type:

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