Top 62 Medicare call center Jobs in California

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
Medicare Benefits Consultant (Tele- Sales)
Clever Care Health Plan —Huntington Beach, CA
- $24 - $29 an hour
- Full-time
- Hybrid work
- Background check
- HIPAA
- Office
7d
Sales Call Center Representative
Oak Street Health —California
- $15.00 - $32.31 an hour
- Full-time
- Remote
- Computer literacy
- High school diploma or GED
- US work authorization
- Health insurance
- Dental insurance
9d
Patient Services Representative I - Remote - Nationwide
Vituity —Sacramento, CA
- $17.12 - $19.04 an hour
- Overtime
- Remote
- Spanish
- Basic math
- Windows
- Profit sharing
- Wellness program
Call Center Supervisor - West Sacramento, CA (Hybrid)
Gainwell Technologies —West Sacramento, CA
- $72,000 - $88,000 a year
- Full-time
- Hybrid work
- Mid-level
- Mentoring
- In-person
- Travel reimbursement
- Profit sharing
9d
Patient Contact Center Patient Services Representative 3
UC Davis Health —Sacramento, CA
- $31.24 - $38.84 an hour
- Overtime
- Background check
- Word processing
- Writing skills
- Continuing education credits
- Paid holidays
6d
Call Center Manager - West Sacramento, CA (Hybrid)
Gainwell Technologies —West Sacramento, CA
- $81,000 - $115,700 a year
- Full-time
- Hybrid work
- 5 years
- In-person
- Senior level
- Travel reimbursement
- Profit sharing
9d
Call Center Quality Assurance Lead - West Sacramento, CA (Hybrid)
Gainwell Technologies —West Sacramento, CA
- $55,300 - $79,000 a year
- Full-time
- Hybrid work
- Mid-level
- Analysis skills
- Continuous improvement
- Travel reimbursement
- Profit sharing
9d
Manager, Appeals & Grievances (Must live or work PST hours)
Molina Healthcare —California
- $73,008 - $135,480 a year
- Full-time
- Surgery
- Medical office experience
- Organizational skills
- Health insurance
Customer Service Representative I
Santa Clara Family Health Plan —San Jose, CA
- $55,958 - $81,139 a year
- Full-time
- Spanish
- Microsoft Outlook
- High school diploma or GED
Call Center Team Lead - West Sacramento, CA (Hybrid)
Gainwell Technologies —West Sacramento, CA
- $60,000 - $72,000 a year
- Full-time
- Hybrid work
- Mid-level
- Supervising experience
- Continuous improvement
- Travel reimbursement
- Profit sharing
8d
Customer Service Representative (Temporary)
Santa Clara Family Health Plan —San Jose, CA
- $26 an hour
- Temporary
- Bilingual
- Spanish
- Microsoft Outlook
Quick Apply
Contact Center Specialist
APLA Health —Los Angeles, CA
- $25.00 - $27.29 an hour
- Full-time
- Hybrid work
- Spanish
- OSHA
- Computer literacy
- Dental insurance
Quick Apply
Contact Center Representative II
L.A. Care Health Plan —Los Angeles, CA
- From $50,216 a year
- Part-time
- Spanish
- HIPAA
- English
- Wellness program
- Health insurance
Call Center Representative
Universal Community Health Center —Los Angeles, CA
- Spanish
- Writing skills
- HIPAA
Quick Apply
1d
Representative, Support Center II (Bilingual English/Spanish. ONSITE Long Beach, CA)
Molina Healthcare —Long Beach, CA
- $20.34 - $30.39 an hour
- Overtime
- Spanish
- Sales
- HIPAA
- Health insurance
9d
Concierge Advocate
SCAN Health Plan —Long Beach, CA
- $22 - $24 an hour
- Full-time
- Background check
- HIPAA
- Research
- Wellness program
- Paid holidays
Quick Apply
1d
Representative, Call Ctr (Part Time)
SACRAMENTO NATIVE AMERICAN HEALTH CENTER INC —Sacramento, CA
- $21 - $23 an hour
- Part-time
- Bilingual
- OSHA
- Computer literacy
- Dental insurance
Quick Apply
14d
Customer Service Representative
SAN JOAQUIN COUNTY HEALTH COMMISSION —Modesto, CA
- $22.36 an hour
- Monday to Friday
- Microsoft Outlook
- Computer literacy
- Basic math
- AD&D insurance
- Paid holidays
Quick Apply
2d
Supervisor, Contact Center
L.A. Care Health Plan —Los Angeles, CA
- $67,186 - $107,498 a year
- Full-time
- Spanish
- HIPAA
- English
- Wellness program
- Health insurance

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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

medicare call center jobs in california

Member Service Representative

Medicare Benefits Consultant (Tele- Sales)

Sales Call Center Representative

Patient Services Representative I - Remote - Nationwide

Call Center Supervisor - West Sacramento, CA (Hybrid)

Patient Contact Center Patient Services Representative 3

Call Center Manager - West Sacramento, CA (Hybrid)

Call Center Quality Assurance Lead - West Sacramento, CA (Hybrid)

Manager, Appeals & Grievances (Must live or work PST hours)

Customer Service Representative I

Call Center Team Lead - West Sacramento, CA (Hybrid)

Customer Service Representative (Temporary)

Contact Center Specialist

Contact Center Representative II

Call Center Representative

Representative, Support Center II (Bilingual English/Spanish. ONSITE Long Beach, CA)

Concierge Advocate

Representative, Call Ctr (Part Time)

Customer Service Representative

Supervisor, Contact Center

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