Customer Solution Center Service Representative IV

Job Category:  Customer Service
Department:  Customer Solution Call Center (321)
Location: 

Los Angeles Garland, California, US

Position Type:  Full Time
Requisition ID:  1101

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

DUTIES
The Customer Solution Center Representative IV has advanced knowledge of healthcare and various managed care product lines, Medi-Cal, PASC, L.A. Care Covered/Cal Medi-Connect and proficient in medical terminology. The CSC Representative IV responsibilities include duties such as: assist supporting queues and Management with projects as needed (e.g. provide informative feedback on desktop procedures, follow-up on member inquiries, CSC Representative shadowing etc.…), acting as back-up support to Call Center Supervisors and Leads. This position handles inbound and outbound interactions involving member eligibility verification, general provider inquiries, claim status (pre-payment), general program and administration questions for all lines of business including direct member request for I.D cards and PCP changes, triage of calls to appropriate unit. Processing payments for L.A. Care Covered members, Document all call interactions in system of record. 

QUALIFICATIONS AND REQUIREMENTS

EDUCATION
Required
High School Diploma

FOREIGN LANGUAGE
Preferred: 
Bilingual in one of L.A. Care Health Plan’s threshold languages:  
English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese

EXPERIENCE
Required
With High School Diploma: 2 years customer service telephone experience in 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. Preferred:

Managed care or health plan experience.

L.A. Care offer a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program


Job Segment: Customer Service Representative, Medical, Call Center Representative, Call Center, Data Entry, Customer Service, Healthcare, Administrative