Customer Service Representative

Prime Healthcare; Ontario (CA); On-site; USD 34,000 - 38,000; Full time

Job summary

Prime Healthcare, an award-winning health system headquartered in Ontario, California, is seeking a Customer Service Representative to serve as the primary contact for members and providers. You will handle incoming calls, guide callers through health plans, and clarify authorization requirements while ensuring accurate documentation.

Candidate should have a high school diploma or GED, customer service experience, and knowledge of self-funded or managed care plans.

Qualifications

• High school diploma or GED required.
• Customer service experience in a fast-paced office setting.
• Ability to handle a high call volume in a professional and courteous manner.
• Working knowledge of self-funded medical plans and/or Managed Care plans.
• Computer literate in Microsoft Office Windows.

Responsibilities

• Serve as primary contact for members and providers, handling incoming calls.
• Guide callers through the health plan and clarify authorization requirements.
• Provide updates regarding referrals and assist with related duties as needed.
• Maintain meticulous documentation and use multiple communication channels.

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities

The Customer Service Representative serves as a primary point of contact for members and providers, handling incoming calls with professionalism and delivering exceptional customer service aimed at achieving first call resolution. This role is crucial in assisting callers by guiding them through the health plan, clarifying authorization requirements, providing updates regarding the status of referrals and assisting with other duties as needed. This position requires proficiency in utilizing multiple communication channels, a strong attention to detail, and meticulous documentation to ensure accurate and efficient service delivery.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

• Effective 01/01/2022 High School Graduate or GED required
• Customer Service experience in a fast-paced office setting
• Ability to handle a high call volume in a professional and courteous manner
• Working knowledge of self-funded medical plans and/or Managed Care plans
• Computer literate in Microsoft Office Windows

Pay Transparency

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $24.39 to $27.81. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf