Top 4993 Member services representative 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
Enrollment Representative
Champion Health Plan —Long Beach, CA
- From $23 an hour
- Overtime
- Background check
- Spanish
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
9d
Sales Representative (Outbound) - Cerritos, CA
IPS Industries, Inc. —Cerritos, CA
- $25 - $45 an hour
- Full-time
- Background check
- Microsoft Excel
- Sales
- Health insurance
- Dental insurance
Quick Apply
Guest Services Representative II "On-Site"
Living Spaces —La Mirada, CA
- $19.15 - $24.85 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Research
- Paid holidays
- Employee assistance program
Quick Apply
7d
Business Development Representative
Revive Medical Supplies —Los Angeles, CA
- $65,000 - $300,000 a year
- Full-time
- Hybrid work
- Background check
- Office
- Business development
- Paid holidays
- Health insurance
Quick Apply
10d
Member Services Representative
Crunch Fitness —Lakewood, CA
- $33,000 - $50,000 a year
- Part-time
- 18 years or older
- CPR Certification
- High school diploma or GED
Quick Apply
Member Services Representative (Part-Time in Whittier)
Careers at F&A Credit Union —Whittier, CA
- $23.00 - $29.25 an hour
- Part-time
- Computer literacy
- Office
- High school diploma or GED
- Profit sharing
- Paid holidays
4d
Front Office Representative I
PIH HEALTH —Whittier, CA
- $23.00 - $29.90 an hour
- Day shift
- Bilingual
- Urgent Care
- High school diploma or GED
Receptionist
Skilled Home Health —Downey, CA
- $20 - $21 an hour
- PRN
- 18 years or older
- CPR Certification
- Word processing
Quick Apply
Member Care Representative I
LBS Financial Credit Union —Cerritos, CA
- $19.75 - $23.45 an hour
- Part-time
- Office
- High school diploma or GED
- Travel
- Tuition reimbursement
- Paid time off
Quick Apply
Credit Union Payment Services Representative
Rancho Federal Credit Union —Downey, CA
- $23.71 - $29.63 an hour
- Full-time
- Background check
- Computer literacy
- English
- Health insurance
- Dental insurance
Quick Apply
8d
Customer Service Representative - State Farm Agent Team Member
Peter Chai - State Farm Agent —Bellflower, CA
- $50,000 - $75,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- 401(k)
Quick Apply
Personal Banker (Member Service Representative III)
SchoolsFirst FCU —Pico Rivera, CA
- $27.02 - $39.18 an hour
- Part-time
- Research
- Mid-level
- Office
Receptionist
California PostAcute Care —Lynwood, CA
- Full-time
- Writing skills
- HIPAA
- High school diploma or GED
Quick Apply
Durable Medical Equipment Medical Biller/Receptionist
Care 4U HME —Downey, CA
- $24 - $30 an hour
- Full-time
- HIPAA
- Administrative experience
- In-person
- Flexible schedule
Quick Apply
Branch Member Service Representative I
L A Federal Credit Union —Cerritos, CA
- $20.86 - $29.33 an hour
- Full-time
- Office
- High school diploma or GED
- Conflict management
Quick Apply
3d
Member Service Representative II
SchoolsFirst FCU —Pico Rivera, CA
- $24.56 - $35.62 an hour
- Part-time
- Research
- Mid-level
- Office
10d
Planet Fitness - Member Services Representative - Part Time - Buena Park
Saber Fitness Buena Park, LLC —Buena Park, CA
- $16.90 - $17.50 an hour
- Part-time
- 18 years or older
- Computer literacy
- High school diploma or GED
Quick Apply
Member Services Representative
SUPREME FITNESS GROUP —Los Angeles, CA
- $18.47 an hour
- Part-time
- 18 years or older
- Computer literacy
- High school diploma or GED
- Health insurance
- 401(k)
Front Desk Representative - Urgent Care, ELA
VIACARE COMMUNITY HEALTH CENTER —Los Angeles, CA
- $24.00 - $26.01 an hour
- Overtime
- Urgent Care
- Administrative experience
- High school diploma or GED
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

member services representative jobs in downey ca

Member Service Representative

Enrollment Representative

Sales Representative (Outbound) - Cerritos, CA

Guest Services Representative II "On-Site"

Business Development Representative

Member Services Representative

Member Services Representative (Part-Time in Whittier)

Front Office Representative I

Receptionist

Member Care Representative I

Credit Union Payment Services Representative

Customer Service Representative - State Farm Agent Team Member

Personal Banker (Member Service Representative III)

Receptionist

Durable Medical Equipment Medical Biller/Receptionist

Branch Member Service Representative I

Member Service Representative II

Planet Fitness - Member Services Representative - Part Time - Buena Park

Member Services Representative

Front Desk Representative - Urgent Care, ELA

I want to receive the latest job alert for member services representative in downey ca

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