Customer Service Representative

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We are transforming healthcare to be value-driven, creating a seamless, consumer-centric care experience that maximizes value for all.

We believe that all health consumers are entitled to high quality, coordinated healthcare. We uniquely align the interests of health consumers, providers, and payors to make high-quality healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.

JOB SUMMARY

The Membership Enrollment - Customer Service Representative I provides support to providers and members by answering calls regarding eligibility, benefits, claims, and service authorizations.

DUTIES & RESPONSIBILITIES

The Membership Enrollment - Customer Service Representative job description is intended to point out major responsibilities within the role, but it is not limited to these items.

• Answering incoming calls from providers and members

• Provides eligibility, claims and authorization status.

• Retrieves voice mails and responds.

• Collaborates with internal and external partners to resolve issues from providers or members as they relate to claims payment, authorization and eligibility inquiries.

• Creates, tracks and completes Customer Service Incidents to internal departments to resolve caller issues.

• Participate in the discovery and resolution of root cause for recurring issues.

• Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships.

• Use customer service best practices to ensure a positive customer experience.

• Meets daily, weekly, monthly metrics as written.

• Other duties and responsibilities as assigned.

EDUCATIONAND PROFESSIONAL EXPERIENCE

(LICENSURES AND CERTIFICATIONS)

• High School diploma or GED required.

• One (1) to three (3) years in the Health Insurance Industry preferred.

• One (1) to three (3) years of customer service experience required.

• Claims payor experience preferred, but not required.

PROFESSIONAL COMPETENCIES

• Strong communication skills, both verbal and written

• Organized and able to prioritize work to meet deadlines

• Able to work independently with little supervision

• Able to thrive in an often-chaotic environment

• Able to understand regulatory and compliance rules

• Results and detail oriented

• To be positive and accountable

• Team unity

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.

For individuals assigned to a location(s) in California, NeueHealth is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant's education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $17.63-$26.44 Hourly. Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; Paid Time Off, and paid holidays.

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

How to Submit an Application:

After reading and knowing the criteria and minimum requirements for qualifications that have been explained from the Customer Service Representative job info - NeueHealth Anaheim, CA above, thus jobseekers who feel they have not met the requirements including education, age, etc. and really feel interested in the latest job vacancies Customer Service Representative job info - NeueHealth Anaheim, CA in 2025-04-10 above, should as soon as possible complete and compile a job application file such as a job application letter, CV or curriculum vitae, FC diploma and transcripts and other supplements as described above, in order to register and take part in the admission selection for new employees in the company referred to, sent via form this bottom.