CalOptima is a mission-driven community-based organization that serves member health with excellence and dignity. The Customer Service Rep will be the first line of contact for members and providers, assisting with inquiries related to Covered California and supporting members by providing information and directing cases to the appropriate operational teams.
Responsibilities
- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability
- Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals/priorities for the department
- Maintains departmental productivity and quality standards
- Responds to and completes all member and provider inquiries or requests during the initial member and provider interaction
- Serves as a resource for other team members
- Addresses member and provider inquiries, questions and concerns in all areas, including eligibility, enrollment, billing, benefits and covered services in-person or telephonically
- Communicates, builds and maintains internal and external relationships by prompt and accurate service delivery
- Identifies and communicates challenges that might arise with the use of professional judgment while adhering to departmental policies and procedures
- Enters accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction
- Completes other projects and duties as assigned
Skills
- High school diploma or equivalent PLUS 6 months of experience in a call center capacity required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying
- Experience with Covered California, health insurance exchange/marketplace and/or commercial Individual and Family Plan required
- Typing speed of 35 words per minute (WPM) required
- Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese)
- 6 months of Covered California call center experience
Benefits
- A comprehensive benefits package CalPERS pension program and additional retirement packages.
- A generous PTO program
- A quality work life balance
- Various wellness programs
- Tuition Reimbursement
- Professional development opportunities
- Career development opportunities
- Flexible scheduling
Company Overview
CalOptima is a county organized health system that provides health insurance programs. It was founded in 1993, and is headquartered in Orange, California, USA, with a workforce of 1001-5000 employees. Its website is https://www.caloptima.org/.