Health Insurance Support Specialist I

The Word & Brown Companies; Orange (CA); Sur place; USD 25 000 - 36 000; Plein temps

Résumé du poste

The Word & Brown Companies seek a Customer Service Rep I to handle calls regarding California Choice plan administration for groups, members, brokers and GAs. You will educate customers, verify enrollments, and resolve provider and billing issues with accuracy and sensitivity.

Ideal candidates have a CA Life & Health license or plan to obtain one within six months, strong communication skills, and experience managing high call volumes in a fast-paced environment.

Qualifications

• CA Life & Health license required; if not present, obtain within six months.
• Excellent verbal and written communication skills under pressure.
• Ability to handle irate customers courteously while maintaining quality and speed.
• Experience in handling high call volumes.
• Proficient with Microsoft Word, Excel and Outlook.
• Accurate data entry; 55 WPM+; Windows and MS Word processing skills.
• Knowledge of health insurance industry and 2+ years customer service preferred.
• Capable of working in a fast-paced environment with deadlines.

Responsabilités

• Answers questions via telephone or email from groups on new hires, billing, rates and procedures.
• Educates employees and dependents on ID cards, coverage and administrative steps.
• Follows up with brokers about issues groups experience with providers.
• Interacts daily with brokers, general agents and sales reps to answer California Choice processes.
• Verifies enrollments and resolves carrier issues; expedites urgent member enrollment.
• Reviews and submits appeal requests from groups.
• Audits group billing and explains results clearly to clients.
• Documents calls in the call tracking system; maintains Doc Link records.
• Maintains HIPAA and PHI guidelines; ensures accurate, timely responses.
• Performs other duties as assigned; attends on-site or remote work as required.

Connaissances

Verbal & written communication

High call volume handling

Typing 55 WPM+

Data entry accuracy

Customer service experience

Formation

CA Life & Health license

High school diploma or equivalent

Outils

MS Word

MS Excel

Outlook

Description du poste

The Word & Brown Companies seek a Customer Service Rep I to handle calls regarding California Choice plan administration for groups, members, brokers and GAs. You will educate customers, verify enrollments, and resolve provider and billing issues with accuracy and sensitivity.

Ideal candidates have a CA Life & Health license or plan to obtain one within six months, strong communication skills, and experience managing high call volumes in a fast-paced environment.