Customer Service Representative

Location: San Jose, California Scope of Work and

Requirements: Customer Service Representative I answers inbound calls and makes outbound calls to support Customer Service Department operations in a manner that maintains compliance with Medicare and Medi-Cal regulatory requirements and achieves Call Center service-level objectives. Act as the primary point of contact and liaison for client's members and providers contacting the plan regarding general inquiries, concerns or requests for information. Answer inbound calls and or place outbound calls in a high call volume environment and work directly with members and providers to accurately and completely answer inquiries involving client's program services and benefits. Educate members and providers on eligibility and medical and pharmacy benefits and how to access services in a manner that achieves excellent service standards and maintains high customer satisfaction. High School Diploma or GED.Minimum one year of experience in Customer Service or Call Center role, preferably within a Health Care, Public Assistance or Human Services programs. Prior experience with managed care plans, Medi-Cal and Medicare programs and working with underserved populations. Bi-lingual skills. Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications, such as Outlook, Word and Excel.