CSR – Customer Service Rep (MediCal) – 100% REMOTE for California Residents Job Vacancy in Suna Inc. San Diego, CA – Latest Jobs in San Diego, CA – updated today

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Company Name : Suna Inc.
Location : San Diego, CA
Position : CSR – Customer Service Rep (MediCal) – 100% REMOTE for California Residents

Job Description : OVERVIEW:
Our client, a US Fortune 500 company and a provider of managed Health care, Pharmacy benefits & specialty areas for managed care organizations / employers / government agencies, seeks an accomplished Customer Care Associate / Customer Service Rep (Remote work for residents anywhere based out of California)
** LOCATION: 100% REMOTE || Candidate should be based out of California
** DURATION: 6 months contract with potential of extension / conversion to FTE
** WORK SHIFTS: Operations are 24x7x365. Shifts are assigned at end of 4-week Training through a bidding process. To be considered, candidate should be available for 2 of 3 shifts & 5 of 7 days (including weekends).

DAY Shift: Start between 6:00am -11:00am Pacific | End between 2:30pm / 8:00pm Pacific
MID-DAY / NIGHT Shift: Start between 11:00am – 2:00pm Pacific | End between 8:00pm – 10:30pm Pacific
OVERNIGHT Shift: 10:30pm-6:30am Pacific

Shift examples: Tue-Sat, 06:00am-2:30pm | Wed-Mon, 10:30am-06:30pm | Mon-Fri, 09:30am-6:30pm
** TRAINING SCHEDULE – FIRST 4 WEEKS:

Mon-Fri | 8:00am-5:00pm Pacific
NO Time-Off policy by client during Training period i.e., 1st4 weeks.

IMPORTANT Remote / Work-From-Home related:

Equipment will be provided.
Candidate MUST have high-speed wired internet connection. Wi-Fi / Wireless connections not allowed as a violation of policy and can lead to breach of Private Health Information (PHI).
Candidate MUST have a reliable home-office environment
Candidate MUST be on camera during training / work hours, especially during attendance call.
Candidate MUST follow business casual dress code during working hours.

RESPONSIBILITIES:

Answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers.
Responsibilities also include administration of intake documentation into the appropriate systems.
Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
Resolves customer administrative concerns as the first line of contact – this may include claim resolutions and other expressions of dissatisfaction.
Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
Educates providers on how to submit claims and when/where to submit a treatment plan.
Informs providers and members on Client’s appeal process.
Links or makes routine referrals and triage decisions not requiring clinical judgment.
Provides information regarding Client’s in-network and out-of-network reimbursement rates and states multiple networks to providers.
Refers callers requesting provider information to Provider Services regarding Client’s professional provider selection criteria and application process.
Refers patients / EAP clients to Client’s Care Management team for a provider, EAP affiliate, or Facility.

QUALIFICATIONS / REQUIREMENTS:

Education: At least High School diploma or equivalent (GED)
Desired: Healthcare Customer Service experience
Flexible and comfortable with change in ever-changing environment of customer service.
Ability to maneuver through various computer platforms while verifying information on phone calls.
Typing speed of 35+ WPM with strong written / verbal communication skills; Must be able to talk and type simultaneously.

I’d love to talk to you if you think this position is right up your alley, and assure a prompt communication, whichever direction. If you are looking for rewarding employment and a company that puts its employees first, we’d like to work with you.
Recruiter Name: Gurjant “Gary” Singh
Title: Lead Recruiter
Company Overview:
Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally: as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them – with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients’ businesses forward.
Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws.
Job Types: Full-time, Contract
Pay: Up to $18.00 per hour
Benefits:

Health insurance

Schedule:

8 hour shift
Day shift
Evening shift
Monday to Friday
Night shift
Weekend availability

Supplemental Pay:

Bonus pay

Education:

High school or equivalent (Required)

Experience:

Customer service: 2 years (Required)
Healthcare Customer service: 1 year (Preferred)

Work Location: Multiple Locations

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