Top 199 Claims representative Jobs in Tustin Ca

Customer Service Representative (Bilingual Korean)
Clever Care Health Plan —Huntington Beach, CA
- $20 - $23 an hour
- Weekends as needed
- Hybrid work
- Background check
- Spanish
- Microsoft Excel
Sales Representative – Insurance Company
Assurixs Insurance Services —Diamond Bar, CA
- $25 - $60 an hour
- Full-time
- Sales
- Office
- Microsoft Office
- Flexible schedule
Quick Apply
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
3PL Customer Service Representative
Scale3PL —Huntington Beach, CA
- $22 an hour
- Full-time
- Bilingual
- Background check
- Customer service
- Health insurance
- Dental insurance
Quick Apply
Dental Treatment Coordinator
Laguna Summit Dental —Laguna Hills, CA
- $26 - $35 an hour
- Full-time
- Dental office
- Mid-level
- Administrative experience
Quick Apply
Workers Compensation Claims Specialist, West
CNA Insurance —Brea, CA
- $54,000 - $103,000 a year
- Full-time
- Hybrid work
- Mid-level
- 3 years
- Analysis skills
Collection Account Specialist I
HealthQuest Esoterics —Irvine, CA
- $22 - $25 an hour
- Full-time
- Medical office experience
- HIPAA
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative (Bilingual Mandarin or Cantonese/English)
KCAL Insurance Agency —Hacienda Heights, CA
- From $20 an hour
- 8 hour shift
- Microsoft Outlook
- Customer service
- English
- Profit sharing
- Paid holidays
Quick Apply
Claims Clerk (Part-Time)
Astiva Health —Orange, CA
- $22 - $23 an hour
- Part-time
- Microsoft Outlook
- Administrative experience
- High school diploma or GED
Quick Apply
Claims Representative (IAP) - Workers Compensation Training Program (On-Site Orange, CA)
Sedgwick —Orange, CA
- Full-time
- Customer service
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
4d
Customer Service Representative - 1st Shift (Hybrid)
Stryker —Irvine, CA
- $23.41 - $30.80 an hour
- Overtime
- Salesforce
- Mid-level
- Office
- Health savings account
- AD&D insurance
Customer Support Representative
Kia Motors America —Irvine, CA
- $54,833.34 - $68,510.76 a year
- Full-time
- Computer literacy
- Mid-level
- Office
- Paid holidays
- Health insurance
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
Warranty Administrator
Volvo Group —Corona, CA
- $30 - $34 an hour
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Dental insurance
Claim Operations Specialist
The Travelers Companies, Inc. —Diamond Bar, CA
- $45,400 - $74,900 a year
- Hybrid work
- Computer literacy
- Office
- High school diploma or GED
- Wellness program
- Paid holidays
Patient Account Specialist III - Santa Ana, CA
KPC GLOBAL MEDICAL CENTERS INC. —Santa Ana, CA
- $31.75 - $38.19 an hour
- Per diem
- Mid-level
- Team management
Quick Apply
Workers Compensation - Claims Associate | Orange, CA
Sedgwick —Orange, CA
- Office
- High school diploma or GED
- Fair chance
- Health savings account
- Disability insurance
Service Delivery Representative II
SchoolsFirst FCU —Tustin, CA
- $22.33 - $32.38 an hour
- Part-time
- Research
- Mid-level
- High school diploma or GED
10d
Senior Workers' Comp Claims Specialist - CA Claims
Zenith Insurance Company —Orange, CA
- $85,736.31 - $127,972.38 a year
- Full-time
- Hybrid work
- 5 years
- High school diploma or GED
- Math
- Paid training
- Paid parental leave
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

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Customer Service Representative (Bilingual Korean)

Clever Care Health Plan -
Huntington Beach, CA

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Job Details

Full-time
$20 - $23 an hour

Qualifications

High school diploma or GED

Full Job Description

Must be available to work from 11:30AM to 8:00PM.
This position operates on a hybrid work schedule. Candidate must reside in Los Angeles or Orange County.

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.

Who Are We? ✨

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values.

Why Join Us?

We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.

Job Summary

Member Advocates are the main point of contact at Clever Care; interfacing with members, prospective members, providers, brokers, and vendors. Serves members by being the main point of contact at Clever Care for member questions and concerns regarding benefits, eligibility, referrals, claims, and any other aspects of plan benefits and services. A successful Member Advocate I ensures member satisfaction by providing superior customer service and displaying a willingness to help at all times while maintaining a professional demeanor.

Member Services Representatives are expected to assess the needs of the caller and determine, based on strong operational understanding, the most appropriate and effective course of action.

Functions & Job Responsibilities

Educates members, family, providers and caregivers regarding benefits and plan options.
Accurately explains benefits and plan options in person, via email, fax, or telephonically.
Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution. Escalates appropriate member issues to management or other departments as required.
Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution. Escalates appropriate member issues to management or other departments as required.
Participates in member calling projects as assigned by management to support the overall Clever Care goal of membership retention.
Follows policies and procedures and job aids in order to maintain efficient and complaint operations; communicates suggestions for improvement and efficiencies to management; identifies and reports problems with workflows following proper departmental procedures; actively participates in departmental staff meetings and training sessions.
Follows all appropriate Federal and State regulatory requirements and guidelines applicable to Clever Care Health Plan operations, as documented I company policies and procedures. Follows all HIPAA requirements.
Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.
Ability to work in an environment where continuous coaching and feedback is the standard practice.

Other duties as assigned

Qualifications

Education and Experience:

High School Diploma or equivalent required.
Bachelor’s Degree or equivalent work experience preferred
Two (2) years Customer Service experience preferably in healthcare management and/or a call center setting

Skills:

Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations
Bilingual in Cantonese, Mandarin, Vietnamese, Korean, Spanish, Thai, Khmer, Japanese may be required.
Exceptional customer service skills, including verbal and written communication
Strong active listening skills
Ability to collaborate and be a team player
Must be a quick learner
Ability to remain calm and courteous when handling upset members and offering solutions to their problems and knowing when to escalate the call
Ability to listen, talk, and type at the same time.
Proficiency with Microsoft Office (Word, Excel, Outlook)
Type 40 wpm. 60 wpm preferred

Other:

Must be willing and able to work some weekends from October-March

Wage Range: $20.00 to $23.00 per hour

Physical & Working Environment.

Physical requirements needed to perform the essential functions of the job, with or without reasonable accommodation:

Must be able to travel when needed or required
Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)
Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.

Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly.

Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and public. May occasionally be required to work irregular hours based on the needs of the business.

Physical & Working Environment.

Physical requirements needed to perform the essential functions of the job, with or without reasonable accommodation:

Must be able to travel when needed or required
Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)
Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.

Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly.

Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Salary ranges posted on the job posting are based on California wages. Salary may be higher or lower depending on the candidate’s state residency.

#LI-Hybrid

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Refine Your Search

claims representative jobs in tustin ca

Customer Service Representative (Bilingual Korean)

Sales Representative – Insurance Company

Member Service Representative

3PL Customer Service Representative

Dental Treatment Coordinator

Workers Compensation Claims Specialist, West

Collection Account Specialist I

Customer Service Representative (Bilingual Mandarin or Cantonese/English)

Claims Clerk (Part-Time)

Claims Representative (IAP) - Workers Compensation Training Program (On-Site Orange, CA)

Customer Service Representative - 1st Shift (Hybrid)

Customer Support Representative

PT Utilities Customer Services Representative I

Warranty Administrator

Claim Operations Specialist

Patient Account Specialist III - Santa Ana, CA

Workers Compensation - Claims Associate | Orange, CA

Service Delivery Representative II

Senior Workers' Comp Claims Specialist - CA Claims

Customer Service Representative I

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