Customer Service Representative

Fresno, California

V Group Inc.
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For more details, please connect withIbad Ullah Khanator email at (see below)

Job Title: Customer Service Representative

Duration: 06 Months

Start Date: ASAP

Location: 505 City Parkway West, CA Orange 92868 (Onsite)

Position Type: Contract

Interview Type: In Person/Web Interview

  • CalOptima Health is seeking a highly motivated an experienced TEMP - Customer Service Representative (Non-Bilingual) to join our team. The Customer Service Representative (CSR) will be the first line of contact for CalOptima Health&s members and providers. The incumbent will assist members and providers with questions and/or complaints related to the Medi-Cal programs for Orange County. The incumbent will provide information regarding eligibility, enrollment, benefits and services to CalOptima Health&s eligible members and providers.

Duties & Responsibilities:

80% - Program Support

  • Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Maintains departmental productivity and quality standards.
  • 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.

15% - Administrative Support

  • 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.

5% - Completes other projects and duties as assigned.

Minimum Qualifications:

  • High School diploma or equivalent required.
  • 6 months of experience in a call center capacity required.
  • Typing speed of 35 words per minute (WPM) required

Preferred Qualifications:

  • 6 months of Medi-Cal/Medicaid or health services experience.
Date Posted: 06 June 2025
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