Top 235 Claims representative Jobs in Los Angeles 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
Healthcare Collections Representative
Leoforce —Los Angeles, CA
- $24 - $28 an hour
- Research
- Analysis skills
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
Business Office Assistant
The Meadows on Sunset Post-Acute —Los Angeles, CA
- $21 - $26 an hour
- Full-time
- Skilled nursing facility
- Customer service
- Office
- Health insurance
- Dental insurance
Quick Apply
1d
Customer Service Associate (Temporary Position)
Bobrick Washroom Equipment —North Hollywood, CA
- $30 an hour
- Temporary
- Basic math
- ERP systems
- Office
- Health savings account
- AD&D insurance
Quick Apply
14d
Auto Liability Claim Rep
Travelers —Diamond Bar, CA
- $67,000 - $110,600 a year
- Mid-level
- Analysis skills
- Bachelor's degree
- Wellness program
- Paid holidays
Claims Representative - IAP (ON-SITE GLENDALE, CA)
Sedgwick —Glendale, CA
- Full-time
- No experience needed
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
8d
Customer Service Representative - State Farm Agent Team Member
Kenny Vuong - State Farm Agent —Monterey Park, CA
- $38,000 - $80,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
Quick Apply
Claims Representative
Mercury Insurance Services, LLC —Los Angeles, CA
- $18.26 - $20.19 an hour
- Microsoft Outlook
- High school diploma or GED
- Conflict management
- Paid training
- Paid holidays
10d
Customer Service Representative - State Farm Agent Team Member
Pogos Ichmelyan - State Farm Agent —Los Angeles, CA
- $50,000 - $75,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
- Opportunities for advancement
Quick Apply
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 Management Assistant (SCAN Temp)
SCAN Health Plan —Long Beach, CA
- $20.14 - $27.77 an hour
- Full-time
- Remote
- Background check
- Microsoft Office
- High school diploma or GED
- Wellness program
- Paid holidays
Quick Apply
6d
Claims Representative (IAP) - Workers Compensation Training Program, Long Beach, CA
Sedgwick —Long Beach, CA
- Full-time
- Customer service
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
14d
Customer Service Representative - State Farm Agent Team Member
Leisha Willis Insurance and Financial Services Inc. —Los Angeles, CA
- $37,440 - $54,080 a year
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Card Services Representative
First Financial Credit Union —Pasadena, CA
- $19.37 - $26.75 an hour
- Full-time
- Microsoft Word
- Microsoft Excel
- Office
- Profit sharing
- Health insurance
Quick Apply
Medi-Cal Collections Representative
UCLA Health —Los Angeles, CA
- $27.65 - $39.27 an hour
- Mid-level
- 3 years
- High school diploma or GED
Property Claims Specialist Field II - CAT/Spikes Team
Mercury Insurance Services, LLC —Brea, CA
- $76,829 - $142,213 a year
- Extended hours
- Bilingual
- Military
- Writing skills
- Paid holidays
- Health insurance
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
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
Customer Service Representative - State Farm Agent Team Member
Chris Barredo - State Farm Agent —Hawaiian Gardens, CA
- $20 - $23 an hour
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- Paid time off
Quick Apply
Field Property Claims Adjuster: Los Angeles, CA (Gateway Cities / Central LA)
Farmers Insurance Group —Los Angeles, CA
- $24.70 - $41.88 an hour
- Microsoft Word
- Background check
- Microsoft Outlook
- Paid training
- Paid parental leave

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

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

claims representative jobs near los angeles ca

Customer Service Representative jobs in Los Angeles, CA

Mental Health Technician jobs in Los Angeles, CA

Customer Service Representative jobs in Bellflower, CA

Claims Representative jobs in Los Angeles, CA

Claims Adjuster jobs in Los Angeles, CA

Member Services Representative jobs in Long Beach, CA

Office Assistant jobs in Los Angeles, CA

Claims Representative jobs in Long Beach, CA

Medical Assistant University Of Texas jobs in Austin, TX

Management Assistant jobs in Margate, FL

Legislative Assistant jobs in Austin, TX

Sports Management jobs in Winston Salem, NC

Management Assistant jobs in San Diego, CA

Management Assistant jobs in San Francisco, CA

Business Management Degree jobs in Houston, TX

Management Assistant jobs in Wheat Ridge, CO

Service Associate jobs in Sumner, WA

Customer Service jobs in Detroit, MI

Associate Degree In Business Administration jobs in Michigan

Service Associate jobs in Glen Mills, PA

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 los angeles ca

Member Service Representative

Healthcare Collections Representative

Business Office Assistant

Customer Service Associate (Temporary Position)

Auto Liability Claim Rep

Claims Representative - IAP (ON-SITE GLENDALE, CA)

Customer Service Representative - State Farm Agent Team Member

Claims Representative

Customer Service Representative - State Farm Agent Team Member

Claims - Field Claims Representative

Medical Management Assistant (SCAN Temp)

Claims Representative (IAP) - Workers Compensation Training Program, Long Beach, CA

Customer Service Representative - State Farm Agent Team Member

Card Services Representative

Medi-Cal Collections Representative

Property Claims Specialist Field II - CAT/Spikes Team

Customer Service Representative - State Farm Agent Team Member

Claims Representative- Healthcare Billing

Customer Service Representative - State Farm Agent Team Member

Field Property Claims Adjuster: Los Angeles, CA (Gateway Cities / Central LA)

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

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected