Customer Service Representative

Unilogic Healthcare Management, LLC.; Cypress (CA); On-site; USD 42,000 - 56,000; Full time

Job summary

Unilogic Healthcare Management, LLC in Cypress, CA is seeking a bilingual Customer Service Representative to handle inbound calls, assist members, and coordinate care with providers. You will maintain 90% quality, average 60 inbound calls daily, document thoroughly, and ensure HIPAA compliance while supporting referrals, billing, eligibility, and transportation needs.

Two years of call-center experience and a high school diploma are required; this role offers stable full-time work in a

Qualifications

• Must be bilingual Spanish/English.
• Minimum of two (2) years of customer service experience in a call center environment.
• High School Diploma or equivalent required.
• Ability to multitask, prioritize and work in a fast-paced environment.
• Knowledge of HIPAA transaction sets, regulations/privacy laws.

Responsibilities

• Answer telephone calls in a prompt, courteous, professional manner and act as liaison between members and care providers.
• Assist with inquiries related to claims, eligibility, referrals, billing, access, transportation, and care coordination.
• Ensure 90-day probationary performance is met and conduct 30/60/90-day evaluations.
• Handle inbound calls (minimum 60 per day) and provide thorough documentation of every call.
• Verify HIPAA requirements to ensure account accuracy and follow up on open issues.
• Escalate recurring issues to management and support team members as needed.
• Assist with member outbound calls when required and perform other duties as assigned.

Skills

Bilingual Spanish/English

Customer service

Call center

Time management

HIPAA knowledge

Education

High School Diploma or equivalent

Job description

This position is responsible for answering telephone calls in a prompt, courteous, professional manner and acting as a liaison between Primary Care Associates of CA/Unilogic Healthcare Management, LLC and members; contracted and non-contracted care providers, ancillary providers; health plans; billing companies; collection companies, to provide assistance and respond to service requests. You will have 30/60/90-day evaluations to determine if the essential duties and responsibilities are being met and if you have passed the 90-day probationary period.

Assist customers on the telephone with inquiries, updates, changes related but not limited to claims, eligibility, referrals, billing, access, transportation, and general coordination of care through thorough

research in a timely manner.

The monthly expectation is to perform at a quality level of 90% accuracy of all measures.

The daily expectation is to efficiently answer a minimum of 60 calls per day (inbound).

100% thorough documentation of every call.

Thoroughly verify HIPAA requirements to ensure account accuracy.

Follow up on all open issues.

Communicate recurring issues and trends to management.

Representative is responsible for being a resource for other team members.

Assist with member outbound calls as needed.

All other duties as assigned.

Qualifications

Must be bilingual Spanish/English speaker.

High School Diploma or equivalent experience.

A minimum of two (2) years of customer service experience in a call center environment required.

Ability to multitask, prioritize and work in a fast-paced environment.

Knowledge of HIPAA transaction sets, regulations/privacy laws.

Skills and Abilities

Excellent communication, organization, and customer service skills.

Proven ability to problem-solve and complete projects with-in appropriate time frames.