Member Experience Specialist

Partnership HealthPlan of California; California (MO); On-site; USD 39,000 - 46,000; Full time

Job summary

Partnership HealthPlan of California is seeking a Customer Service Representative to respond to member and provider issues in our call center, ensuring questions are resolved or directed to the appropriate person for resolution and delivering the highest level of service. You will document calls, escalate when needed, and collaborate with internal departments to resolve issues.

Enrollment duties and data entry in online systems are part of daily tasks, with bilingual skills preferred for

Qualifications

• High school diploma or equivalent.
• Minimum 1 year Call Center experience in an MCO setting.
• Customer service experience preferred.
• Bilingual skills in Spanish, Tagalog, or Russian preferred.

Responsibilities

• Responds to member and provider issues in the member services queue.
• Documents calls as appropriate.
• Escalates calls to Lead Member Services Representative or Management as needed.
• Works with internal departments, providers, and external organizations to resolve issues as needed.
• Reviews all incoming e-mails to ensure compliance with instructions affecting processes/benefits.
• Processes enrollment duties as assigned.
• Enters data in relevant online systems.
• Other duties as assigned.

Skills

Verbal communication

Written communication

Typing 25 wpm

Bilingual (Spanish/Tagalog/Russian)

Education

High school diploma or equivalent

Job description

Partnership HealthPlan of California is seeking a Customer Service Representative to respond to member and provider issues in our call center, ensuring questions are resolved or directed to the appropriate person for resolution and delivering the highest level of service. You will document calls, escalate when needed, and collaborate with internal departments to resolve issues.

Enrollment duties and data entry in online systems are part of daily tasks, with bilingual skills preferred for