OVERVIEW:

Our client—a leading provider of Health, Dental, Vision, Medicaid, and Medicare plans in California, serving 4.7 million members with $22.9B in annual revenue—is seeking an experienced Healthcare Customer Service Representative.

IMPORTANT NOTES:

Fully remote role (California residents only)
6-month contract with potential to hire
Schedule: Mon–Fri, 9:00 AM–6:00 PM (Pacific Time)
Must have high-speed wired internet (Wi-Fi not allowed)
Must have a reliable home office setup

RESPONSIBILITIES:

Serve as the first point of contact for providers and members
Support medical/disease management through calls, emails, and data entry
Assign inpatient length of stay and approve home health/DME services within scope
Process authorization requests and referrals
Provide administrative support, including system letters, data entry, and case manager assistance
Handle intake tasks (voicemail, faxes), enter HIPAA authorizations, and manage SNF admissions
Respond to basic inquiry calls and support with CM mailings, templates, and forms

QUALIFICATIONS:

High school diploma or equivalent required
3+ years of healthcare CSR or prior authorization experience in a healthcare call center
Proficient in MS Outlook, Word, Excel, and electronic record systems
Strong written and verbal communication skills with providers, members, and patients
Knowledge of managed healthcare

Blue Shield of California jobs

Healthcare Call Center Representative

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