Customer Service Rep I in Cypress, CA at Beacon Health Options

Date Posted: 11/12/2019

Job Snapshot

Job Description

Under the direction of the Customer Service Management Team, the Customer Service Representative (CSR) for answering and responding to a high volume of telephone inquiries from members and providers. The incumbent’s responsibilities include providing accurate and thorough interpretation of benefits, eligibility, provider participation, claims payment and interpretation inquiries, resolving customer inquiries, facilitating problem resolution, and acting as a member/provider advocate by meeting or exceeding customers’ expectations.  The CSR is expected to take complete responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention and satisfy corporate customer service goals and objectives. 

Shift: M- F 11:00am – 8:00pm (schedule may vary)

What does a typical day look like?

Essential Duties and Responsibilities: The CSR will perform the following duties in a typical call center environment, which means a high volume of calls will handled while located at a desk.      Which requires adherence to schedules and extended periods of time on the phone.

  1. Provide timely, accurate, and courteous responses to a high volume of telephone inquiries from both members and providers.
  2. Meet daily production standards as indicated by management to meet overall ASA/ABA and client PG’s: includes attendance, adherence to schedules, ACW, calls per day, turnaround times.
  3. Maintain adherence to schedule enabling the team to meet client satisfaction levels. Adherence to work schedule including time spent on break/lunch.
  4. Achieve and maintain productivity and quality performance expectations; minimum 95%
  5. Interpret and effectively communicate benefits and eligibility and claims payment information to our customers.
  6. Document all critical information related to contacts responded to in the appropriate in house healthcare systems
  7. Demonstrate professionalism, empathy and a sense of urgency on each and every member and provider call/transaction
  8. Effectively navigate through multiple complex systems/screens.
  9. Have the knowledge around handling escalated calls
  10. Provide timely follow-up with other internal departments to expedite resolution of difficult/aging inquiries, and when necessary escalate those issues to management for further handling.
  11. Keep abreast of all system, contractual, compliance standard changes and policy updates, and attend additional training sessions and department meetings as necessary.
  12. Complete daily assigned tasks by management such as website inquiries, COB coordination of benefit updates, and authorization for disclosure forms, authorization updates, and correspondence.
  13. Perform additional duties and/or work additional hours as needed. Overtime and working holidays may be required based on business needs.
  14. Comply with all the HIPAA Compliance regulations.

What you Contribute?

Education: A high school/GED diploma is required.  An Associate’s Degree or equivalent related experience is preferred.

Licensure: N/A

Knowledge, Skills & Abilities:

  • 6 months – 1 year experience in Customer Service, Health Care or Health Insurance is required. Previous experience in an ACD call center environment is preferred.
  • Strong interpersonal skills and good written and verbal communication skills.
  • Computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint.

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original thinkers.
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & wellbeing incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work
  • Tuition reimbursement so you can keep reaching your fullest potential

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email ( Only candidates who have applied for an open position through our Careers page ( will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.