Job Description

Job Description

Job Title: Call Center Representative

Pay Rate: $23.84 per hour

Number of Positions: 18 (all open)

Location: San Diego, CA

• Training will be onsite for 6 weeks, followed by 1–2 weeks onsite or remote.
• Possible remote work option available after training and successful assessments (dedicated workstation required).

Schedule:

• Start Date: October 30, 2025
• Orientation: October 30–31, 2025
• Training: Monday–Friday, 8:30 AM – 5:00 PM (onsite)
• Post-training work shifts: Monday–Friday, 8:00 AM–6:00 PM or 11:30 AM–8:00 PM, with possible weekends.
• Must be flexible to support business needs.
• 40 hours per week | 8 hours per day.

Position Purpose

Responsible for high-quality communication with members, providers, employer groups, internal departments, and external agencies.

Key Responsibilities

Customer Care

• Deliver accurate information on health plan benefits, policies, and procedures.
• Use judgment to select appropriate resources to assist callers.
• Maintain customer-focused service in line with organizational standards.

Problem Resolution

• Research, investigate, and resolve member concerns and grievances.
• Manage 60–80 inbound and outbound calls daily in a fast-paced environment.
• Support service recovery efforts and ensure compliance with HIPAA and Medicare guidelines.

Required Skills & Experience

• Minimum 6 months of recent call center experience (required).
• At least 1 year of overall customer service experience.
• Healthcare call center experience strongly preferred.
• Proven ability to meet and exceed KPIs in a structured environment.
• Strong interpersonal, investigatory, and problem-solving skills.
• Excellent verbal/written communication and computer skills.
• Experience with Epic and TalkDesk (preferred).
• Ability to work long-term assignments (not short stints).

Education & Certifications

• High School Diploma or equivalent (required).
• Medical Office Certification, including Medical Technology (preferred).

Additional Notes

• Strict KPI standards must be met to remain compliant with role expectations.
• This is a fast-paced environment requiring flexibility, accuracy, and professionalism.

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