Top 335 call center representative Jobs in fullerton, 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
Sales & Service Development Representative II
Mutual of Omaha Mortgage —Irvine, CA
- $26 an hour
- Full-time
- Mid-level
- In-person
- Communication skills
- Paid holidays
- Health insurance
Quick Apply
Member Services Representative (Korean Speaking)
ASTIVA HEALTH INC —Orange, CA
- $24 - $29 an hour
- Full-time
- Bilingual
- Customer service
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
NOW HIRING! Tele-Sales and Customer Service Agents Wanted!
Curetax Financial —Irvine, CA
- $68,100 - $225,000 a year
- Full-time
- Sales
- Customer service
- Computer literacy
Quick Apply
Inbound Sales Only - Personal Lines Insurance Agent
H Morales Farmers Insurance Agency —Irvine, CA
- $28 - $45 an hour
- Full-time
- Background check
- Sales
- Writing skills
- Health insurance
- Paid time off
Quick Apply
Dispatcher (Customer Service Rep)
Dial One Sonshine Plumbing, Heating, A/C & Electrical —Santa Ana, CA
- $23 - $30 an hour
- Full-time
- Background check
- Spanish
- Pass drug screening
- Health insurance
- Dental insurance
Quick Apply
Call Center Representative
Santa Ana Federal Credit Union —Santa Ana, CA
- $21.85 - $30.61 an hour
- Full-time
- Background check
- Spanish
- English
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative/Dispatcher
Pulse Final Mile —Walnut, CA
- $20 - $22 an hour
- Weekends as needed
- Microsoft Excel
- Microsoft Outlook
- In-person
- Health insurance
- Dental insurance
Quick Apply
Provider Service Representative I
United Faith Ministries Inc —Orange, CA
- $24 an hour
- Full-time
- High school diploma or GED
- Analysis skills
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
8d
Call Center Member Service Representative
United Faith Ministries Inc —Orange, CA
- $25 an hour
- Overtime
- Microsoft Outlook
- Computer literacy
- Research
- Health insurance
- Dental insurance
Quick Apply
Customer Service Representative
CalOptima —Orange, CA
- Weekends as needed
- Background check
- Microsoft Outlook
- Writing skills
- Tuition reimbursement
- Paid time off
3d
Customer Service Representative, Associate
Byram Healthcare Centers Inc —Anaheim, CA
- $23 an hour
- Full-time
- Microsoft Office
- High school diploma or GED
- 1 year
- Paid parental leave
- Disability insurance
Quick Apply
14d
Customer Service Representative I
Nexus Water Group —La Mirada, CA
- $22 - $26 an hour
- Full-time
- Spanish
- Microsoft Outlook
- Office
- Health insurance
- Dental insurance
Advice Representative - Nurse Advice Call Center
Providence —Brea, CA
- $24.00 - $29.57 an hour
- Part-time
- Microsoft Word
- Hospital
- Mid-level
- Paid parental leave
- Paid holidays
Customer Service Representative
Smart Care Solutions —Anaheim, CA
- $22 - $26 an hour
- Urgently hiring
- Writing skills
- Pass drug screening
- Mid-level
Call Center Customer Service Representative
Mesa Garage Doors, Inc. —Anaheim, CA
- $22 an hour
- Weekends as needed
- Communication skills
- Entry level
Member Contact Center Representative I
LBS Financial Credit Union —Westminster, CA
- $20 - $22 an hour
- Part-time
- Computer literacy
- Research
- High school diploma or GED
- Tuition reimbursement
- Paid time off
Quick Apply
Member Service (Contact Center) Representative 1
American First Credit Union —Brea, CA
- $19.64 - $24.56 an hour
- Full-time
- Spanish
- Computer literacy
- In-person
- AD&D insurance
- Paid holidays
Quick Apply
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
Client Service Representative
Adeedo! —Fullerton, CA
- $20 - $24 an hour
- Spanish
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
9d

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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 representative jobs in fullerton, ca

Member Service Representative

Sales & Service Development Representative II

Member Services Representative (Korean Speaking)

NOW HIRING! Tele-Sales and Customer Service Agents Wanted!

Inbound Sales Only - Personal Lines Insurance Agent

Dispatcher (Customer Service Rep)

Call Center Representative

Customer Service Representative/Dispatcher

Provider Service Representative I

Call Center Member Service Representative

Customer Service Representative

Customer Service Representative, Associate

Customer Service Representative I

Advice Representative - Nurse Advice Call Center

Customer Service Representative

Call Center Customer Service Representative

Member Contact Center Representative I

Member Service (Contact Center) Representative 1

Call Center Representative, Part Time

Client Service Representative

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