What are the responsibilities and job description for the Customer Service Representative- Healthcare position at Sunshine Enterprise USA LLC?
Company Overview : Our client is a leading healthcare located in Orange, CA, seeking a senior customer service representative, performing as a point of contact for questions and / or complaints related to plan services.
Position Summary : The ideal candidate shall have at least 1 year of call center capacity at a healthcare setting.
Expected Start Date : February 3rd, 2025
Work hours : Monday - Friday, 8 : 30 am ~ 5 : 30 pm
Work Duration : Up to 6 months
Job Type : On-site
Position Responsibilities
- Follows through on and completes all member and provider inquiries or requests during the original member and provider interaction.
- Serves as a resource for other team members.
- Assists the team in carrying out department responsibilities and collaborates with others to support short and long-term goals / priorities for the department.
- Addresses member and provider inquiries, questions and concerns in all areas including eligibility, enrollment, claims or authorization status, benefit interpretation and referrals / authorizations for medical care in-person or telephonically
- Enters accurate and complete documentation into internal application systems regarding all concerns and / or inquiries from the member and provider interaction.
- Communicates, builds and maintains internal and external relationships by prompt and accurate service delivery.
- Identifies and communicates challenges that might arise with the use of professional judgment while adhering to departmental policies and procedures.
- Completes other duties or projects as assigned.
Experience & Education
Necessary Attributes :
Please see HR for information on physical demands and work environment of this job.
Sunshine Enterprise USA is an “Equal Opportunity Employer—Minorities, Females, Veterans and Disabled Persons”
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