Top 313 Call center Jobs in Fountain Valley, 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
IN-OFFICE Customer Service Agent Representative
Riman Inc —Irvine, CA
- $47,000 - $50,000 a year
- Full-time
- Computer skills
- In-person
- 1 year
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative Bilingual - Spanish
Sonus Hearing Care Professionals —Westminster, CA
- $18 an hour
- Full-time
- Background check
- Spanish
- Microsoft Excel
- Paid holidays
- Health insurance
Quick Apply
Call Center Quality Assurance Auditor
United Faith Ministries Inc —Orange, CA
- $26 an hour
- Full-time
- Spanish
- HIPAA
- English
- 403(b) matching
- Health insurance
Quick Apply
Cold Call Recruiter
First Team Real Estate —Newport Beach, CA
- $65,000 - $170,000 a year
- Full-time
- Background check
- High school diploma or GED
- In-person
- Health insurance
- Dental insurance
Quick Apply
4d
Call Center Scheduling Coordinator
ACSC Management Services Inc —Costa Mesa, CA
- $25.03 - $33.34 an hour
- Weekends as needed
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Paid parental leave
- Health insurance
10d
Member Contact Center Representative I
LBS Financial Credit Union —Westminster, CA
- $19.75 - $24.00 an hour
- Part-time
- Computer literacy
- Research
- High school diploma or GED
- Tuition reimbursement
- Paid time off
Quick Apply
12d
Customer Service Representative I
WESTERN GROWERS GROUP —Irvine, CA
- $35,288.32 - $45,874.31 a year
- Full-time
- Remote
- Spanish
- Data analysis skills
- HIPAA
Quick Apply
Member Contact Center Representative II
LBS Financial Credit Union —Westminster, CA
- $22.46 - $26.68 an hour
- Full-time
- Computer literacy
- Research
- High school diploma or GED
- AD&D insurance
- Paid holidays
Quick Apply
6d
Claims Resolution Specialist (Customer Service)
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Microsoft Outlook
- Writing skills
- Tuition reimbursement
- Paid time off
10d
PT Utilities Customer Services Representative I
City of Anaheim, CA —Anaheim, CA
- $27.77 - $35.14 an hour
- Part-time
- Background check
- Sales
- Computer literacy
- Retirement plan
12d
Call Center Customer Service Representative
Mesa Garage Doors, Inc. —Anaheim, CA
- $22 an hour
- Weekends as needed
- Communication skills
- Entry level
Intake Coordinator
CareConnect Health Services Inc —Costa Mesa, CA
- Full-time
- Hybrid work
- Microsoft Outlook
- Mid-level
- High school diploma or GED
- COVID-19 protective measures
Quick Apply
Member Contact Center Specialist
LBS Financial Credit Union —Westminster, CA
- $28.42 - $35.52 an hour
- Full-time
- 3 years
- High school diploma or GED
- Bachelor's degree
- AD&D insurance
- Paid holidays
Quick Apply
9d
Call Center Representative, Part Time
West Coast University, Inc. —Irvine, CA
- $21.43 - $28.95 an hour
- Part-time
- Mid-level
- High school diploma or GED
- 1 year
Customer Service Call Center
Fletcher Jones Management West —Irvine, CA
- $20 an hour
- Communication skills
- Entry level
- Disability insurance
- Health insurance
Quick Apply
Customer Service Rep / Call Center / Client Support
ADP —La Palma, CA
- $17.02 - $30.14 an hour
- Overtime
- Hybrid work
- Spanish
- Military
- Writing skills
- Wellness program
- Disability insurance
Call Center Representative - Part Time
West Coast University, Inc. —Anaheim, CA
- $21.43 - $28.95 an hour
- Part-time
- Mid-level
- High school diploma or GED
- 1 year
10d
Customer Service Representative I
WESTERN GROWERS ASSURANCE TRUST —Irvine, CA
- $35,288.33 - $45,874.31 a year
- Full-time
- Remote
- Spanish
- Data analysis skills
- HIPAA
Quick Apply
10d
Call Center Representative, Full Time
American Career College —Irvine, CA
- $21.43 - $28.95 an hour
- Full-time
- Mid-level
- High school diploma or GED
- 1 year

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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

call center jobs in fountain valley, ca

Member Service Representative

IN-OFFICE Customer Service Agent Representative

Customer Service Representative Bilingual - Spanish

Call Center Quality Assurance Auditor

Cold Call Recruiter

Call Center Scheduling Coordinator

Member Contact Center Representative I

Customer Service Representative I

Member Contact Center Representative II

Claims Resolution Specialist (Customer Service)

PT Utilities Customer Services Representative I

Call Center Customer Service Representative

Intake Coordinator

Member Contact Center Specialist

Call Center Representative, Part Time

Customer Service Call Center

Customer Service Rep / Call Center / Client Support

Call Center Representative - Part Time

Customer Service Representative I

Call Center Representative, Full Time

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