Customer Solution Center Service Representative II Job at L.A. Care Health Plan

Customer Solution Center Service Representative II

Job Category: Customer Service

Department: Customer Solution Call Center

Location: Los Angeles, CA, US, 90017

Position Type: Full Time

Requisition ID: 11602

Salary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.)

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.

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.

The Customer Solution Center (CSC) Representative II has advanced knowledge of healthcare and various managed care product lines, including Medi-Cal and L.A. Care Covered. Responsibilities include assisting management with projects, acting as back-up support to Call Center Leads, handling inbound and outbound interactions, verifying member eligibility, and processing payments.

Duties

1. Answers incoming calls for all product lines from members, potential members, providers, and advocates.
2. Handles and resolves member issues, assists members in connecting with internal units or external parties.
3. Provides essential information to members regarding access to care issues, benefits, and other inquiries.
4. Documents all calls via the member database systems.
5. Ensures department compliance with HIPAA regulations.
6. Troubleshoots and directs calls to the appropriate departments or outside entities.
7. Processes payments for L.A. Care Covered members.
8. Supports robocall and ad-hoc member outreach activities.
9. Performs other duties as assigned.

Education and Experience

Required: At least 1 year of customer service call center experience in a healthcare environment. Data entry experience with the 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.

Skills

Required: Knowledge of medical terminology. Good understanding of service to the disadvantaged population, seniors, and/or people with chronic conditions or disabilities. Must be a quick learner, excellent team player, and customer service oriented.

Preferred: Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable.

Physical Requirements

Light

Additional Information

The L.A. Care Health Plan Call Center is available 24 hours a day, 7 days a week, including holidays. Call Center work shifts are assigned based on business need and may include evenings, weekends, and holidays.

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

L.A. Care offers a wide range of benefits including:

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