Compassionate Healthcare Call Center Agent

Shield California Health; Morgan Hill (CA); On-site; USD 26,000 - 28,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Flexible Spending Account

Life & Disability Insurance

401(k) with Company Match

Paid Holidays

Paid Vacation and Sick Days

Education Assistance

Job summary

Shield HealthCare is seeking a Call Center Customer Service Agent to assist patients, caregivers and providers with telephone orders in a on-site Valencia, CA location. The role focuses on delivering accurate information, processing orders, coordinating insurance requirements and providing compassionate support in a HIPAA-compliant call center.

You will handle inbound/outbound calls, educate callers on product usage, verify demographics, and collaborate with clinical teams to resolve issues

Qualifications

• High School diploma or equivalent.
• 1-2 years customer service experience.
• Proficiency in Microsoft 365 (Excel, Outlook, PowerPoint, Word, SharePoint, Teams) and other standard productivity tools.
• Demonstrated problem solving ability.
• Typing 35 wpm required.
• Experience in a call center, healthcare support, pharmacy, DME/HME, or disease‑management program.
• Strong communication skills with the ability to explain information clearly and compassionately.
• Ability to handle high volumes of calls while maintaining accuracy and professionalism.
• Strong attention to detail, especially when documenting patient interactions.
• Ability to maintain patient confidentiality and comply with HIPAA regulations.
• Bilingual a plus, not required.

Responsibilities

• Respond to inbound calls from patients, caregivers, and healthcare providers regarding enteral nutrition supplies, formula options, order status, and service inquiries.
• Handle all customer calls in a professional manner and exceed customer expectations
• Process new referrals, including verifying patient demographics, clinical documentation, and prescription details.
• Coordinate insurance verification, including coverage checks, prior authorizations, and documentation requirements.
• Place and manage orders for enteral formula, supplies, pumps, and related equipment in accordance with company protocols and payer guidelines.
• Educate callers on product usage, delivery schedules, reorder timelines, and general product expectations.
• Document all interactions accurately in the system, ensuring compliance with HIPAA and internal quality standards.
• Collaborate with clinical teams, dietitians, and customer service departments to resolve issues and support continuity of care as needed.
• Resolve common customer concerns, identifying urgent or complex cases and escalating appropriately to clinical or supervisory staff.
• Maintain up‑to‑date knowledge of organization product offerings, insurance policies, and regulatory requirements.
• Check hold screen, daily, in an effort to release customer orders in a timely manner and meet hold screen expectations
• Maintain an available phone status in adherence with published shift and activity schedules
• Meet performance metrics, including call quality, call volume, accuracy, and customer satisfaction targets.
• Other duties assigned specific to product lines
• Complete daily assignments and tasks given by management
• Completes special projects as assigned, supporting team and organizational objectives and continuous improvement initiatives

Education

High School diploma or equivalent

Tools

Microsoft 365

Excel

Outlook

PowerPoint

Word

SharePoint

Teams

Job description

Shield HealthCare is seeking a Call Center Customer Service Agent to assist patients, caregivers and providers with telephone orders in a on-site Valencia, CA location. The role focuses on delivering accurate information, processing orders, coordinating insurance requirements and providing compassionate support in a HIPAA-compliant call center.

You will handle inbound/outbound calls, educate callers on product usage, verify demographics, and collaborate with clinical teams to resolve issues