Posted 20 Nov 2023, 7:35 pm
Senior Member Services Representative at Central California Alliance for Health
We have an opportunity to join the Alliance as a Senior Member Services Representative in the Member Services Call Center Department.
There is one position available in our Mariposa service area and will be on-site Monday through Friday in the Mariposa County offices.
WHAT YOU'LL BE RESPONSIBLE FOR
- Responds to complex member issues and acts as a technical resource for Member Services Representatives
- Acts as a frontline customer service representative within the Member Services Department, providing assistance to members and providers primarily by phone
- Assists with special projects, as assigned
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here.
- Knowledge of:
- Bilingual (English/Spanish or English/Hmong) preferred for Mariposa County only
- Principles and practices of customer service
- Managed health care in a health plan environment
- Eligibility processes and guidelines associated with one or more of the following: the Medi-Cal program, Social Security programs, foster care, adoption assistance, and/or other public assistance programs
- Conflict resolution techniques
- Windows-based PC systems and Microsoft Word, Outlook and Excel, and database systems
- Ability to:
- Answer telephone calls promptly and minimize delays that may lead to missed calls
- Act as a technical resource for Member Services Representatives
- De-escalate complex situations, including complaints
- Translate healthcare-related terminology and complex processes into simple language and step-by-step instructions when communicating with members and providers
- Gather and evaluate information, ask appropriate questions and utilize active listening and problem-solving skills
- Education and Experience:
- High school diploma or equivalent
- Four years of customer service experience in member services, health care, public assistance, human services or in a customer service or call center environment which included a minimum of two years of experience in a health care setting which involved assisting members and/or providers with eligibility processes and guidelines (an Associate’s degree may substitute for one year of the general customer service experience); or an equivalent combination of education and experience may be qualifying
- While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
- Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
- Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.
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Source: Remote Ok