Top 190 Claims representative Jobs in Glendale 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
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
Bilingual Property & Casualty Customer Service Representative - Remote (11575)
Leverages U.S. Inc. (Shigotosagashi.com) —Torrance, CA
- $60,000 - $80,000 an hour
- Full-time
- English
- Mid-level
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
10d
Customer Service Representative (Bilingual Korean)
Clever Care Health Plan —Arcadia, CA
- $20 - $23 an hour
- Weekends as needed
- Hybrid work
- Background check
- Spanish
- Microsoft Excel
10d
AFLAC Benefits Consultant
Aflac - Encino, CA —Encino, CA
- $35,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Word
- 18 years or older
- Microsoft Excel
- Dental insurance
- Paid time off
Quick Apply
Sales Support Coordinator
AppleOne —City of Industry, CA
- $60,000 - $80,000 a year
- Day shift
- Spanish
- Microsoft Excel
- English
- Mileage reimbursement
- Health insurance
Quick Apply
11d
Pre-Registration Representative
UCLA Health —Los Angeles, CA
- $30.36 - $43.49 an hour
- Mid-level
- Typing
- Medical terminology
6d
Claims - Field Claims Representative
The Cincinnati Insurance Companies —Los Angeles, CA
- $71,250 - $112,500 a year
- Day shift
- Mid-level
- Driver's License
- Bachelor's degree
- Paid time off
- 401(k) matching
Medical Billing Customer Representative
UCLA Health —Los Angeles, CA
- $30.79 - $40.60 an hour
- Mid-level
- 2 years
- Communication skills
13d
Medi-Cal Collections Representative
UCLA Health —Los Angeles, CA
- $27.65 - $39.27 an hour
- Mid-level
- 3 years
- High school diploma or GED
Claims Representative- Healthcare Billing
Vista Del Mar —Los Angeles, CA
- $28 - $30 an hour
- Mid-level
- Administrative experience
- Children
- Paid holidays
- Health insurance
Quick Apply
Senior Customer Service Representative
Optum —Los Angeles, CA
- $18 - $32 an hour
- 8 hour shift
- Remote
- 18 years or older
- Computer literacy
- Medical office experience
- On-the-job training
1d
ESIS Senior Claims Representative, WC
Chubb —Chatsworth, CA
- $78,100 - $105,000 a year
- Full-time
- Hybrid work
- Customer service
- Mid-level
- Office
Account Representative - USC Care MSO CBO - Full Time 8 Hour Days (Non-Exempt)(Non-Union)
USC —Pasadena, CA
- $26.00 - $41.28 an hour
- 8 hour shift
- Customer service
- Research
- Mid-level
Admitting Representative
AHMC Healthcare —San Gabriel, CA
- From $27.03 an hour
- On call
- Computer literacy
- HIPAA
- Windows
Property Claims Specialist
Mercury Insurance Services, LLC —Los Angeles, CA
- $36,381 - $77,881 a year
- Overtime
- Remote
- Bilingual
- Military
- Mid-level
- Paid holidays
- Health insurance
ESIS Claims Representative, WC
Chubb —Chatsworth, CA
- $62,700 - $81,300 a year
- Full-time
- Writing skills
- Mid-level
- Analysis skills
Medical Support Assistant (Advanced)
US Veterans Health Administration —Los Angeles, CA
- $56,247 - $73,121 a year
- Part-time
- Hybrid work
- Background check
- High school
- Writing skills
14d
Collections Representative
Quest Diagnostics —West Hills, CA
- $20.44 - $26.00 an hour
- Full-time
- Remote
- 18 years or older
- HIPAA
- Research
- Employee stock purchase plan
- Disability insurance
Quick Apply
12d
Collector
City of Hope —Irwindale, CA
- $22.07 - $31.11 an hour
- Full-time
- 5 years
- Mid-level
- High school diploma or GED

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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

claims representative jobs in glendale ca

Member Service Representative

Customer Service Representative (Bilingual Mandarin or Cantonese/English)

Bilingual Property & Casualty Customer Service Representative - Remote (11575)

Customer Service Representative (Bilingual Korean)

AFLAC Benefits Consultant

Sales Support Coordinator

Pre-Registration Representative

Claims - Field Claims Representative

Medical Billing Customer Representative

Medi-Cal Collections Representative

Claims Representative- Healthcare Billing

Senior Customer Service Representative

ESIS Senior Claims Representative, WC

Account Representative - USC Care MSO CBO - Full Time 8 Hour Days (Non-Exempt)(Non-Union)

Admitting Representative

Property Claims Specialist

ESIS Claims Representative, WC

Medical Support Assistant (Advanced)

Collections Representative

Collector

I want to receive the latest job alert for claims representative in glendale ca

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