Top 53694 Referral Service Representative Jobs

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
Patient Financial Services Representative
E-Solutions IT Services Private Limited —Whittier, CA
- $21 - $23 an hour
- Call employer
- Background check
- In-person
- 1 year
Quick Apply
Patient Service Representative II
Solaris Health Holdings LLC —Tallahassee, FL
- Full-time
- OSHA
- HIPAA
- High school diploma or GED
- Health savings account
Quick Apply
Customer Service Representative / Call Center Representative (Job #33357)
InnoSource —Kent, OH
- $15 an hour
- Full-time
- Hybrid work
- Background check
- Windows
- Microsoft Office
- Paid training
- Health insurance
Quick Apply
4d
Call Center Representative
Institute on Aging —San Francisco, CA
- $27 - $32 an hour
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Referral Representative-Orthopedics
TEXASCONNECT INC —Remote
- Full-time
- Remote
- Mid-level
- Administrative experience
- High school diploma or GED
AR Call Representative 1
Performance Home Medical —Houston, TX
- Full-time
- Remote
- Entry level
- AD&D insurance
- Paid holidays
Quick Apply
Customer Service Representative
Credit Solutions LLC —Remote
- Full-time
- Remote
- HIPAA
- High school diploma or GED
- Communication skills
- Paid holidays
- Health insurance
Quick Apply
Community Referral Representative
The Pacific Homecare LLC —Maryland
- $2,000 - $4,000 a month
- Part-time
- Remote
- Surgery
- HIPAA
- High school diploma or GED
- Work from home
- Flexible schedule
Quick Apply
12d
Referral Representative-Eye Care
TEXASCONNECT INC —Remote
- Full-time
- Remote
- Mid-level
- Administrative experience
- High school diploma or GED
Remote Healthcare Call Center Representative
Conduent Commercial Solutions, LLC —Remote
- $16 an hour
- Weekends as needed
- Remote
- Background check
- Computer literacy
- High school diploma or GED
- Paid training
- Paid holidays
Customer Service Representative
ibex Limited —Washington, DC
- Weekends as needed
- 18 years or older
- HIPAA
- High school diploma or GED
- Paid training
- Opportunities for advancement
Customer Service Representative
OrthoAtlanta —Atlanta, GA
- Full-time
- Writing skills
- Medical office experience
- Mid-level
Quick Apply
Member Support Representative Lead
Foodsmart —Remote
- $60,000 - $75,000 a year
- Weekends as needed
- Remote
- Mid-level
- Supervising experience
- Case management
- Health insurance
- Dental insurance
Quick Apply
11d
Customer Service Representative
Optum —Lakewood, CO
- $16 - $29 an hour
- 8 hour shift
- 18 years or older
- Computer literacy
- Pass drug screening
- Paid training
Customer Service Representative
Covenir BPO —Charlotte, NC
- $17 - $19 an hour
- Full-time
- Remote
- Spanish
- English
- Mid-level
- Paid training
- Health savings account
Quick Apply
4d
Branch Coordinator - Remote
Apria Healthcare LLC —Los Angeles, CA
- $20 - $25 an hour
- Full-time
- Remote
- Computer literacy
- Writing skills
- English
- Paid parental leave
- Disability insurance
Quick Apply
Intake Coordinator
BioTek reMEDys —Remote
- From $50,000 a year
- Extended hours
- Background check
- HIPAA
- Administrative experience
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative
Trescal Inc. —Irving, TX
- Mid-level
- High school diploma or GED
- 2 years
- AD&D insurance
- Disability insurance
Quick Apply
Call Representative
PHYSICIANS GROUP SERVICES, PA —Orange Park, FL
- Call employer
- Word processing
- Medical office experience
- HIPAA
- Paid holidays
- Health insurance
Quick Apply

I want to receive the latest job alert for Referral Service Representative

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

Referral Service Representative jobs near

Customer Service Representative jobs in Lakewood, CO

Customer Service Representative jobs in Remote

Customer Service Representative jobs in Atlanta, GA

Customer Service Representative jobs in Kent, OH

Member Services Representative jobs in Long Beach, CA

Call Center Representative jobs in Remote

Customer Service Representative jobs in Irving, TX

Call Center Representative jobs in San Francisco, CA

Customer Service Representative jobs in Charlotte, NC

Call Representative jobs in Orange Park, FL

Member Services Representative jobs in Remote

Customer Service Representative jobs in Washington, DC

Intake Coordinator jobs in Remote

Customer Support Representative jobs in Remote

Remote Call Center Representative No Experience jobs in Texas

Customer Service Representative jobs in New Jersey

Customer Service Representative jobs in Toledo, OH

Customer Service jobs in Detroit, MI

Customer Service Representative jobs in Torrance, CA

Customer Service Representative jobs in Round Rock, TX

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

Referral Service Representative jobs

Member Service Representative

Patient Financial Services Representative

Patient Service Representative II

Customer Service Representative / Call Center Representative (Job #33357)

Call Center Representative

Referral Representative-Orthopedics

AR Call Representative 1

Customer Service Representative

Community Referral Representative

Referral Representative-Eye Care

Remote Healthcare Call Center Representative

Customer Service Representative

Customer Service Representative

Member Support Representative Lead

Customer Service Representative

Customer Service Representative

Branch Coordinator - Remote

Intake Coordinator

Customer Service Representative

Call Representative

I want to receive the latest job alert for Referral Service Representative

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected