L.A. Care Health Plan · 3 hours ago
Customer Solution Center Service Representative I
1200 Building
Full-time
Onsite
New Grad, Entry Level
$46K/yr - $56K/yr
0+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, providing health coverage to low-income residents of Los Angeles County. The Customer Solution Center Service Representative I is responsible for handling first level calls, assisting members with eligibility verification, benefits, and coordination of care, while ensuring compliance with HIPAA regulations.
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Responsibilities
Answers incoming first level calls from members, potential members, providers and advocates
Handles and resolves member issues, assists members in connecting with internal units or external parties such as Plan Partners, Primary Care Physician (PCP) offices, pharmacists, etc
Provides essential information to members regarding access to care issues, coordination of care issues, benefits, Evidence of Coverage (EOC), Member Handbook, etc
Assists providers in using the Interactive Voice Response (IVR) web portal and verifying member eligibility
Documents all calls via the member data base system, QMEIS
Ensures department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information
Troubleshoots and directs calls to the appropriate departments or outside entities. (75%)
Supports robocall and ad-hoc member outreach activities as determined by business need. (15%)
Perform other duties as assigned. (10%)
Qualification
Required
High School Diploma/or High School Equivalency Certificate
At least 6 months of customer service call center experience
Data entry experience with ability to type a minimum of 40 words per minute
Ability to answer a high volume of calls
Knowledge of medical terminology
Must be a strong team player, punctual, and has excellent attendance record
Good understanding of service to the disadvantaged population, seniors and or people with chronic conditions or disabilities
Must be a quick learner, excellent team player and customer service oriented
Preferred
Managed care or health plan experience
Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese
Benefits
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)
Company
L.A. Care Health Plan
L.A. Care’s mission is to provide access to quality health care for L.A.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Melanie Rainer
Chief Strategy and Transformation Officer
Recent News
2026-01-17
MarketScreener
2025-08-27
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