Customer Service Representative

October 8, 2019
San Jose, CA
Job Type


Customer Service Rep needed for a contract opportunity with Yoh’s client located in San Jose, CA!

Top Skills You Should Possess:

  • Previous experience in a call center or customer service setting

What You’ll Be Doing:

  • The Customer Service Representative answers inbound calls and makes outbound calls to support Customer Service Department operations in a manner that maintains compliance with Medicare and Medi-Cal regulatory requirements and achieves Call Center service-level objectives
  • Act as the primary point of contact and liaison for members and providers contacting the plan regarding general inquiries, concerns or requests for information
  • Develop a general understanding of all member facing materials, communications and interactions and be prepared to respond appropriately to follow up calls
  • Answer inbound calls and/or place outbound calls in a high call volume environment and work directly with members and providers to accurately and completely answer inquiries involving program services and benefits
  • Follow established guidelines and resources to respond to member and provider inquiries and resolve concerns in an accurate, timely, professional, and culturally competent manner
  • Intake, handle and coordinate member grievances, appeals and billing issues, escalating to the Grievance and Appeals department, when necessary
  • Educate members and providers on eligibility, and medical and pharmacy benefits and how to access services in a manner that achieves excellent service standards and maintains high customer satisfaction
  • Use listening skills and judgment to appropriately categorize and accurately document all contacts and follow-up actions regarding member and provider communications and activities in accordance with established guidelines

What You Need to Bring to the Table:

  • High School Diploma or GED
  • Minimum one year of experience in Customer Service or Call Center role, preferably within a Health Care, Public Assistance or Human Services programs
  • Prior experience with managed care plans, Medi-Cal and Medicare programs, and working with underserved populations
  • Ability to meet Key Performance Indicators by participating in and achieving the standards of the Customer Service Call Center Quality Program
  • Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications, such as Outlook, Word and Excel
  • Ability to use a keyboard with moderate speed and a high level of accuracy
  •   Excellent communication skills including the ability to express oneself clearly and concisely when providing service to members and providers over the telephone, in person or in writing
  • Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes
  • Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position
  • Spanish, Vietnamese, Chinese, or Tagalog language bi-lingual skills preferred

What’s In It For You?

We welcome you to be a part of the largest global staffing companies to meet your career aspirations. Yoh’s network of client companies has been employing professionals like you for over 65 years in the U.S., UK and Canada. Join Yoh’s extensive talent community that will provide you with access to Yoh’s vast network of opportunities.

  • Medical, Dental & Vision Benefits
  • 401K Retirement Saving Plan
  • Life & Disability Insurance
  • Direct Deposit & weekly EPayroll
  • Employee Discount Programs
  • Referral Bonus Programs

What are you waiting for?  Apply Now!

Recruiter:  Jennifer Andersen

Yoh makes finding and applying for jobs simple. Partner with Yoh to find the right opportunities across multiple industries in the US and UK. Find out more here!

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Click here to contact us if you are an individual with a disability and require accommodation in the application process.

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