Top 119379 Jobs in Downey, CA

Member Service Representative
Champion Health Plan/ Champion Payer Solutions —Long Beach, CA
- From $22 an hour
- Weekends as needed
- Spanish
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
Quick Apply
Financial Aid Assistant
Career Academy of Beauty —Garden Grove, CA
- $26 - $28 an hour
- Part-time
- Background check
- Office
- High school diploma or GED
- Paid time off
- Retirement plan
Quick Apply
Part-Time GMP & HACCP Manager
Breadmasters Ara-Z Inc —Commerce, CA
- $35 - $45 an hour
- Part-time
- Hybrid work
- Mid-level
- Manufacturing
- Communication skills
Quick Apply
10d
Apparel Production Assistant
Rockstar Original —Vernon, CA
- $18 - $23 an hour
- Full-time
- Spanish
- Microsoft Excel
- ERP systems
- Health insurance
- 401(k)
Quick Apply
Career Services Business Developer
National Polytechnic College —Lakewood, CA
- $21 - $25 an hour
- 8 hour shift
- Hybrid work
- Microsoft Outlook
- Business development experience
- Driver's License
- Health insurance
- Dental insurance
Quick Apply
Painter
Adecco USA, Inc. —Whittier, CA
- $20 - $22 an hour
- Temporary
- In-person
- Entry level
- Health insurance
- Dental insurance
6d
Meat Packer
Sysco —Vernon, CA
- $10 - $48 an hour
- Heavy lifting
- Customer service
- Basic math
Dining Room Host
Chick-fil-A —Downey, CA
- Full-time
- Serving
- No experience needed
- Quick service & fast food restaurant
- Flexible schedule
School Recpetionist
St. Pius X - St. Matthias Academy —Downey, CA
- From $23 an hour
- Full-time
- Background check
- School experience
- Spanish
- Health savings account
- Health insurance
Quick Apply
6d
Production (Laundry) Workers
Emerald Textiles —Commerce, CA
- From $20.55 an hour
- Overtime
- High school diploma or GED
- Ability to lift 50 pounds
- Warehouse
- Disability insurance
- Health insurance
Quick Apply
6d
Store Support
Home Depot —Downey, CA
- $20 - $22 an hour
- Entry level
- Time management
Day Time Front Counter Team Member
Chick-fil-A —Downey, CA
- Full-time
- Serving
- No experience needed
- Quick service & fast food restaurant
- Flexible schedule
Late Night Front Counter Team Member
Chick-fil-A —Downey, CA
- Full-time
- Serving
- No experience needed
- Quick service & fast food restaurant
- Flexible schedule
Loss Prevention Associate
Walmart —Downey, CA
- $20 - $33 an hour
- Full-time
- High school
- Mid-level
- Paid jury duty
- Disability insurance
Membership Sales Associate
LA Fitness —Downey, CA
- $17.25 - $25.00 an hour
- Full-time
- Sales
- In-person
- Marketing
- Mileage reimbursement
- Health insurance
Quick Apply
Gardener
Stay Green Inc. —Santa Fe Springs, CA
- $18 - $20 an hour
- Full-time
- Spanish
- High school diploma or GED
- Ability to lift 50 pounds
Quick Apply
RTV Clerk
Costco Wholesale Corporation —Norwalk, CA
- Entry level
- AD&D insurance
- Employee stock purchase plan
Loss Prevention Clerk
Costco Wholesale Corporation —Norwalk, CA
- Entry level
- AD&D insurance
- Employee stock purchase plan
Evening Front Counter Team Member
Chick-fil-A —Downey, CA
- Full-time
- Serving
- No experience needed
- Quick service & fast food restaurant
- Flexible schedule
Visitation Assistant
Rose Hills —Whittier, CA
- $20.00 - $22.50 an hour
- Part-time
- Background check
- Serving
- Clean driving record
- 401(k)
Quick Apply

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Member Service Representative

Champion Health Plan/ Champion Payer Solutions
Long Beach, CA

Quick Apply

Job Details

Full-time
From $22 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Flexible schedule

Qualifications

Spanish
Customer communication
Teamwork
Customer retention
Managed care
Managed care organization experience
Call center experience
HIPAA
English
Vietnamese
High school diploma or GED
Medical terminology

Full Job Description

SCOPE OF ROLE

The Member Service Representative (MSR) serves as the first point of contact for customers, providers, and advocates, ensuring exceptional customer experiences through accurate and helpful communication. This role involves handling incoming calls from Medicare Advantage members, assisting with benefit inquiries, referrals, claims, and guiding them to community resources as needed. The ideal candidate will be bilingual, proficient in medical terminology, and knowledgeable in CMS, Medicare, and HIPAA regulations. Strong proficiency in Microsoft Applications and a commitment to delivering top-tier service are essential.

ROLE RESPONSIBILITIES

The Member Service Representative job description is intended to point out major responsibilities within the role, but it is not limited to these functions:

KEY RESPONSIBILITIES % OF TIME

 Serve as the primary point of contact for customers, providers, and advocates, handling calls with professionalism and courtesy.

 Provide clear, concise, and accurate information to ensure customers fully understand their benefits, referrals, claims, and available resources.

 Ensure prompt and efficient service by answering all incoming calls within the

department’s established time frame.

 Escalate complex issues to management or relevant departments as necessary to

ensure customer concerns are thoroughly addressed.

 Collaborate with internal teams to resolve problems and enhance overall customer

satisfaction.

 Accurately document customer interactions, including actions taken, resolutions

provided, and any follow-up required.

 Adhere to department policies and HIPAA regulations to maintain confidentiality and

security of member information.

 Manage complaints, grievances, and appeals efficiently according to department

protocols.

 Assist in onboarding and training new staff, sharing knowledge and best practices.

 Complete required training promptly to stay current with procedures, systems, and

regulations.

 Consistently meet or exceed standards for quality, productivity, and adherence to

schedules.

 Participate in outbound call campaigns for welcome calls, enrollment verification calls, appointment scheduling,

retention efforts, and other health-related programs.

 Contribute to policy and procedure development related to customer experience.

 Stay updated on CMS, Medicare, and HIPAA regulations to ensure compliance and

provide accurate information.

 Utilize medical terminology and healthcare knowledge to assist members with inquiries.

 Adapt to changes in shifts, responsibilities, and operational needs as required.

 Facilitate member requests for provider changes, transportation, and other assistance.

 Maintain a positive attitude and practice excellent customer service principles.

 Perform other duties as assigned to contribute to the team and department’s success

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

 High School diploma or GED required.

 Associate degree (AA) degree (preferred).

 Minimum (2) or more years of direct customer service EXPERIENCE

 Knowledge of Medi-Cal, Medicare Managed Care Plans.

 Medical front office experience preferred.

PROFESSIONAL COMPETENCIES

 Strong communication skills (verbal and written).

 Highly organized with the ability to prioritize work to meet deadlines.

 Strong adaptability and openness to change.

 Knowledge of HIPAA regulations with a commitment to data privacy.

 Strategic skills in problem-solving, critical thinking, and innovation.

 Ability to collaborate effectively with business partners throughout the organization.

 Experience assisting members with Medicare Advantage or HMO, including referrals and authorizations.

 Outbound/inbound call center experience with a focus on problem-solving and escalation.

 Bilingual in English/Spanish or Vietnamese/English required.

 Proficiency in Microsoft Applications (Word, Excel, Outlook).

 Ability to multitask and prioritize tasks effectively.

 Flexibility to work varying shifts, including evenings and weekends.

LICENSURES AND CERTIFICATIONS

No licensures or certifications are required.

WORK ENVIRONMENT and ESSENTIAL PHYSICAL FUNCITONS:

Work Environment:

 Must be available for scheduling 7 days a week, including evenings, overnights, weekends, and holidays.

 Shifts may change based on operational needs; flexibility is essential.

Essential Physical Functions:

 Ability to work onsite in an open office setting, primarily sitting at a desk and working on a computer.

 Regularly required to talk, hear, stand, walk, sit, and use hands to handle or feel objects and controls.

 Frequently lifts/moves up to 10 pounds. Specific vision abilities include close vision and the ability to adjust focus.

EEO/AFFIRMATIVE ACTION STATEMENT

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse group of employees committed to meeting the needs of Champion Payer Solutions/ Champion Health Plan, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Job Type: Full-time

Pay: From $22.00 per hour

Benefits:

401(k)
Dental insurance
Flexible schedule
Health insurance
Paid time off
Vision insurance

Experience:

Managed care: 2 years (Required)

Language:

Spanish (Preferred)
Vietnamese (Preferred)

Ability to Commute:

Long Beach, CA 90815 (Required)

Ability to Relocate:

Long Beach, CA 90815: Relocate before starting work (Preferred)

Work Location: In person

Quick Apply

Refine Your Search

jobs in Downey, CA

Member Service Representative

Financial Aid Assistant

Part-Time GMP & HACCP Manager

Apparel Production Assistant

Career Services Business Developer

Painter

Meat Packer

Dining Room Host

School Recpetionist

Production (Laundry) Workers

Store Support

Day Time Front Counter Team Member

Late Night Front Counter Team Member

Loss Prevention Associate

Membership Sales Associate

Gardener

RTV Clerk

Loss Prevention Clerk

Evening Front Counter Team Member

Visitation Assistant

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