Customer Care Representative

Overview

We are seeking customer-focused Member Services Representatives to support a high-volume healthcare enrollment program during the annual Open Enrollment period. This role is ideal for candidates with call center and healthcare customer service experience who thrive in a fast-paced environment and are passionate about helping members understand and enroll in health benefits.

This position offers the opportunity to gain valuable healthcare industry experience, with the potential for long-term employment for top performers seeking career growth.

Key Responsibilities

• Handle high-volume inbound calls regarding health plan enrollment and benefits
• Educate members on medical, dental, vision, and supplemental benefit options
• Assist with plan selection, enrollment changes, and qualifying life event requests
• Verify member eligibility and enrollment status
• Explain premiums, deductibles, copays, coinsurance, and out-of-pocket costs
• Research and resolve member inquiries with strong investigatory skills
• Troubleshoot enrollment issues and escalate complex cases when necessary
• Accurately document customer interactions within CRM and enrollment systems
• Maintain compliance with HIPAA regulations and company policies
• Meet established quality, productivity, and customer satisfaction metrics
• Deliver exceptional customer service during peak Open Enrollment periods

Required Qualifications

• Minimum 6 months of recent call center experience
• Healthcare call center or health insurance experience strongly preferred
• Experience handling high call volumes (60-80 calls per day)
• Familiarity with Medicare, HIPAA compliance, service recovery, and grievance resolution
• Proven ability to meet and maintain KPI and performance metrics
• Strong computer, data entry, and written communication skills
• Ability to navigate multiple systems while speaking with customers
• Stable work history demonstrating reliability and commitment

Preferred Qualifications

• Previous Open Enrollment experience
• Epic experience
• TalkDesk experience
• Knowledge of Health Maintenance Organizations (HMOs)
• Experience researching and resolving complex customer inquiries

Training Information

Training is mandatory and completed onsite.

Phase 1 Training (6 Weeks)

• Location: 8695 Spectrum Center Blvd, San Diego, CA
• Schedule: Monday-Friday, 8:30 AM - 5:00 PM

Phase 2 Training (1-2 Weeks)

• Onsite training while taking live calls

Candidates must be available to attend training in person every day.

Work Location

After training, employees will work onsite at:

8520 Tech Way

San Diego, CA

Schedule Requirements

Candidates must be flexible to work assigned schedules based on business needs, including:

• Monday-Friday between 8:00 AM and 6:00 PM
• 11:30 AM to 8:00 PM shifts
• Occasional weekends as needed

Ideal Candidate

We're looking for individuals who are seeking a long-term career opportunity, enjoy helping others, can perform in a metrics-driven environment, and are comfortable handling a high volume of inbound member calls while maintaining superior customer service.

This is a Contract position based out of San Diego, CA.

The pay range for this position is $25.00 - $25.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a fully onsite position in San Diego