Top 3027 Member services representative 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
Temporary Medical Collections Representative
University of California, Irvine —Anaheim, CA
- $26.58 - $37.75 an hour
- Temporary
- Background check
- English
- Research
- Paid holidays
- Health insurance
Customer Service Representative
Mechanics Bank —Newport Beach, CA
- $20 - $25 an hour
- Full-time
- Office
- Residential
- High school diploma or GED
- Free parking
- Commuter assistance
9d
Teller (Member Service Representative I)
SchoolsFirst FCU —Costa Mesa, CA
- $22.00 - $31.90 an hour
- Part-time
- Office
- High school diploma or GED
- 1 year
4d
Patient Services Representative - Front Desk - Seal Beach, CA
Pacific Dermatology Specialists —Seal Beach, CA
- $22 - $25 an hour
- 8 hour shift
- Spanish
- Ability to walk for extended periods
- Ability to climb stairs
Quick Apply
DEPARTMENT SERVICES AIDE
City of Huntington Beach, CA —Huntington Beach, CA
- $17.77 - $29.63 an hour
- Temporary
- Current TB test
- Word processing
- Writing skills
Patient Account Registrar
Garden Grove Hospital Medical Center —Garden Grove, CA
- $26.51 an hour
- Per diem
- Acute care
- Hospital
- Adults
14d
IT Helpdesk Support Technician
Sofia University —Costa Mesa, CA
- $25 an hour
- Part-time
- Hybrid work
- Microsoft Office
- University
- US work authorization
Quick Apply
AL Med-Tech
Carmel Village —Fountain Valley, CA
- $19 - $22 an hour
- Overtime
- 18 years or older
- Residential
- First Aid Certification
Quick Apply
Member Services Representative
Crunch - SIR Fitness LLC. —Fountain Valley, CA
- $16.90 - $18.00 an hour
- Full-time
- CPR Certification
- Entry level
- AED Certification
- Employee discount
- Gym membership
Quick Apply
Patient Office Representative II
City of Hope —Newport Beach, CA
- $22.07 - $28.73 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Clinic
Admitting Representative, Admitting Per Diem
CHOC Children's —Orange, CA
- $23 - $24 an hour
- Part-time
- Microsoft Excel
- Customer service
- BLS Certification
Support Services Representative
Southland Credit Union —Los Alamitos, CA
- $24 - $31 an hour
- Full-time
- Microsoft Excel
- Writing skills
- Research
Member Services Representative
SUPREME FITNESS GROUP —Fountain Valley, CA
- $16.90 an hour
- Part-time
- 18 years or older
- Computer literacy
- High school diploma or GED
- Health insurance
- 401(k)
Member Services Representative
Crunch Fitness —Cerritos, 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
Astiva Health —Orange, CA
- $24 - $29 an hour
- Full-time
- Background check
- Spanish
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Electronic Services Representative I
LBS Financial Credit Union —Westminster, CA
- $22.46 - $24.57 an hour
- Weekends as needed
- Microsoft Outlook
- Research
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
4d
Patient Office Representative II - Irvine Sand Canyon
City of Hope —Irvine, CA
- $22.07 - $28.73 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Clinic
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
Creators Club Attendant
Great Maple —Anaheim, CA
- $25 an hour
- Weekends as needed
- English
- Ability to stand for extended periods
- Restaurant
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 fountain valley, ca

Member Service Representative

Temporary Medical Collections Representative

Customer Service Representative

Teller (Member Service Representative I)

Patient Services Representative - Front Desk - Seal Beach, CA

DEPARTMENT SERVICES AIDE

Patient Account Registrar

IT Helpdesk Support Technician

AL Med-Tech

Member Services Representative

Patient Office Representative II

Admitting Representative, Admitting Per Diem

Support Services Representative

Member Services Representative

Member Services Representative

Member Services Representative

Electronic Services Representative I

Patient Office Representative II - Irvine Sand Canyon

Member Care Representative I

Creators Club Attendant

I want to receive the latest job alert for member services representative in fountain valley, ca

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