Covered California Member Support Specialist

CalOptima; Orange (CA); Hybrid; USD 48,000 - 65,000; Full time

Benefits offered by this job

Competitive compensation

Comprehensive benefits package

CalPERS pension program

Flexible scheduling

Professional development opportunities

Tuition Reimbursement

Job summary

CalOptima is seeking a Customer Service Representative for Covered California. You will be the first line of contact for members and providers, handling inquiries about eligibility, benefits, and services.

The role requires careful documentation and collaboration with internal teams to resolve issues efficiently. The position supports a mission-driven, member-focused culture with potential for telework within California and in-office presence as needed.

Qualifications

• High school diploma or equivalent PLUS 6 months of experience in a call center capacity; an equivalent combination of education and experience may qualify.
• Experience with Covered California health insurance exchange/marketplace and/or commercial plans required.
• Typing speed of 35 words per minute (WPM) required.

Responsibilities

• Serve as the first point of contact for members and providers regarding Covered California questions or complaints.
• Assist with eligibility, benefits and covered services information and route cases to appropriate teams.
• Document accurately in internal systems and maintain relationships with internal and external stakeholders.
• Support ongoing department goals and contribute to a high-quality, member-focused customer service culture.

Skills

Customer service

Communication

Typing speed 35 WPM

Education

High school diploma or equivalent

Tools

Microsoft Office (Word, Outlook, Excel, PowerPoint)

Job description

CalOptima is seeking a Customer Service Representative for Covered California. You will be the first line of contact for members and providers, handling inquiries about eligibility, benefits, and services.

The role requires careful documentation and collaboration with internal teams to resolve issues efficiently. The position supports a mission-driven, member-focused culture with potential for telework within California and in-office presence as needed.