Healthcare Customer Service Associate

SCFHP South County Resident Advisory Group; San Jose (CA); Presencial; USD 56.000 - 81.000; Jornada completa

Descripción de la vacante

Santa Clara Family Health Plan is seeking a Customer Service Representative I to handle inbound and outbound calls, supporting the Customer Service Department while ensuring compliance with Medicare and Medi-Cal regulatory requirements and achieving call center service level objectives.

You will assist members and providers with questions about eligibility, benefits and access to services, document interactions, escalate issues when needed, and participate in ongoing training to maintain high

Formación

• High School Diploma or GED required.
• Minimum one year of experience in Customer Service or Call Center.
• Bilingual skills in Spanish, Vietnamese, Chinese, or Tagalog preferred.
• Proficiency with Outlook, Word, and Excel.

Responsabilidades

• Serve as primary contact for members and providers via inbound/outbound calls.
• Explain plan services and benefits; resolve inquiries.
• Document contacts and follow-ups per guidelines.
• Triages requests to other departments as needed.
• Handle member grievances, appeals, and billing issues.
• Participate in daily/weekly/monthly meetings and training.
• Educate members on eligibility and access to services.
• Maintain confidentiality and comply with policies.

Conocimientos

Bilingual (Spanish, Vietnamese,Chinese

Communication skills

Keyboarding

Confidentiality

Office software

Educación

High School Diploma or GED

Herramientas

Outlook

Word

Excel

Descripción del empleo

Santa Clara Family Health Plan is seeking a Customer Service Representative I to handle inbound and outbound calls, supporting the Customer Service Department while ensuring compliance with Medicare and Medi-Cal regulatory requirements and achieving call center service level objectives.

You will assist members and providers with questions about eligibility, benefits and access to services, document interactions, escalate issues when needed, and participate in ongoing training to maintain high