Customer Service Representative I

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $20 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💝 Customer Support

🚫👨‍🎓 No degree required

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The Word & Brown Companies

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1984

⚕️ Healthcare Insurance

🤝 B2B

Healthcare Insurance • B2B

The Word & Brown Companies is a family of insurance administration businesses that simplify access to health insurance and employee benefits for individuals, families, brokers, carriers, employers, and employees. Founded in 1985, they provide specialized products, services, and tools across health insurance administration, employee benefits, and related healthcare services, emphasizing service excellence, innovation, and a strong company culture. The company operates as a B2B partner to brokers, carriers, and employers while directly supporting consumers with benefit access and administration.

📋 Description

• Understanding of company policies and procedures as they apply to California Choice/Choice Builder plans. • Answers questions by telephone from groups regarding new hires, billings, rates, supplies, administrative procedures, etc. • Educates, via telephone, employees/dependents regarding PCP’s, ID cards, RX problems, administrative procedures, dependent coverage, address changes, etc. • Follows-up on calls and emails from brokers regarding problems that their groups are experiencing with providers. • Ability to interact with brokers, general agents and sales representatives on a daily basis and must be able to answer questions regarding California Choice processes. • Responds to calls from providers to confirm eligibility and benefits. • Verifies enrollments and resolves issues with carriers. • Expedites processing of members enrollment with carrier if urgent services are needed. • Review and submit appeal requests from groups. • Review /Audit group billing and explain to clients in clear and accurate manner. • Document calls in call tracking system. • Departmental standard requires each Customer Service Representative to provide Service of Unequalled Excellence to all callers by maintaining an average of 90% or greater on Call Reviews. • Answer at least 100% of the daily call volume average. • Provide clear and explicit documentation while maintaining percentage at a level of 90% or higher daily. • Make busy time of 20 minutes or less per day. • Meet department standards for quality and quantity of work. • Meet department and team standards for turnaround times. • Adhere to all HIPAA (Health Insurance Portability and Accountability Act) and PHI (Personal Health Information) guidelines. • On-site regular attendance and punctuality are essential functions of the job. • Performs other business tasks or functions as assigned.

🎯 Requirements

• At least two (2) years of customer service experience preferred. • Knowledge of the health insurance industry and customer service experience preferred. • Ability to handle irate customers in a courteous, patient, calm and positive manner while maintaining a high quality and quantity of work. • Experience in handling high call volume. • CA Life & Health license required. If successful applicant does not have insurance license, it is required to obtain one within six (6) months of date of hire. • Must have excellent verbal and written communication skills, especially under pressure. • Must be computer literate in Microsoft Word, Excel and Outlook. Accurate data entry skills a must. Typing at 55 WPM or more. • Must be able to work in a fast-paced environment where deadlines are a priority and handling multiple assignments simultaneously. • Problem Solving Skills required. • Must have a proficient knowledge of the English language. • Proficient knowledge of the Spanish language is a plus. If hired as a Bilingual representative, Language Assistance Certification is required every two (2) years.

🏖️ Benefits

• Health insurance • Paid time off • Professional development opportunities