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Customer Service Representative jobs at John Little – State Farm Agent - 824 jobs

  • Customer Relations Representative - State Farm Agent Team Member

    John Proctor-State Farm Agent 3.3company rating

    Customer service representative job at John Little – State Farm Agent

    State Farm Insurance Agent located in Portland, OR is seeking an outgoing, career-oriented professional to join their team. As a State Farm team member for John Proctor - State Farm Agent, you will build and develop customer relationships within the community to promote State Farm products including auto, home and life insurance. Responsibilities Establish customer relationships and follow up with customers, as needed. Provide prompt, accurate, and friendly customer service. Service can include responding to inquiries regarding insurance availability, eligibility, coverages, policy changes, transfers, claim submissions, and billing clarification. Use a customer-focused, needs-based review process to educate customers about insurance options. Develop leads, schedule appointments, identify customer needs, and market appropriate products and services. As an Agent Team Member, you will receive... Salary plus commission/bonus Paid time off (vacation and personal/sick days) Valuable experience Growth potential/Opportunity for advancement within my agency Requirements Detail oriented Proactive in problem solving Ability to effectively relate to a customer Bilingual - Spanish preferred Property and Casualty license (must be able to obtain) Life and Health license (must be able to obtain) If you are motivated to succeed and can see yourself in this role, please complete our application. We will follow up with you on the next steps in the interview process. This position is with a State Farm independent contractor agent, not with State Farm Insurance Companies. Employees of State Farm agents must be able to successfully complete any applicable licensing requirements and training programs. State Farm agents are independent contractors who hire their own employees. State Farm agents employees are not employees of State Farm.
    $37k-43k yearly est. 23d ago
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  • Customer Service Specialist - Work From Home

    American Income Life Ao 4.2company rating

    Oakland, CA jobs

    About the job Customer Service Specialist - Work From Home About Us We are the worlds only 100% union-label supplemental benefits provider, proudly serving over 40,000 unions and associations worldwide. For more than 60 years, weve specialized in delivering supplemental and permanent benefit solutions to hardworking families who depend on us for financial protection and peace of mind. Position Overview Were seeking motivated, service-oriented individuals to join our remote team. Youll work directly with union members who have requested benefits informationhelping them understand their options and guiding them through the enrollment process. Key Responsibilities Manage inbound and outbound calls with prospective clients Schedule and conduct virtual benefits presentations Educate members on available programs and coverage options Accurately complete applications and related documentation Maintain high service standards and organized client records Participate in ongoing leadership training and development Qualifications Excellent communication and interpersonal skills Positive, energetic, and professional attitude Customer service or sales experience (preferred, not required) Basic computer skills and comfort in a digital work environment Team player with the ability to collaborate at all levels Legally authorized to work in the U.S. or Canada What We Offer Full benefits package after initial period 100% remote work no commuting required Flexible scheduling to fit your lifestyle Weekly pay plus performance-based monthly bonuses Annual incentive trips to destinations like Cancun, the Bahamas, and Las Vegas for top performers Clear career growth paths with fast-track promotion opportunities If you're passionate about helping others, eager to grow in a supportive environment, and ready for a career that offers flexibility, growth, and high earning potential apply today and take the first step toward a meaningful future.
    $34k-43k yearly est. 2d ago
  • Customer Service Specialist Remote

    American Income Life Insurance Company 4.2company rating

    Orlando, FL jobs

    We are looking for an individual with great customer service skills for one of the main supplemental benefits companies in the nation for over 65 years! The Company is expanding in our territories and we are in immediate need of dedicated Benefits Representatives with ambitious goals. Requirements Excellent communication skills Basic computer knowledge Work ethics Outgoing, fun & energetic with an upbeat personality Accountability and coachability Time management skills Pass a criminal background check Benefits (after 90 days) Paid weekly Bonuses Health Insurance Reimbursement Life Insurance Retirement Plan Requirements: Computer Cell phone (unlimited long distance calling) Access to Wifi Powered by JazzHR
    $27k-35k yearly est. 2d ago
  • Customer Service Rep - Work From Home

    American Income Life Insurance Company 4.2company rating

    Fort Worth, TX jobs

    (DUE TO COVID-19 IN EFFORT TO EMBRACE SOCIAL DISTANCING THE COMPANY OVERVIEW WILL BE CONDUCTED ONLINE VIA ZOOM) We are looking for an individual with great customer service skills for one of the main supplemental benefits companies in the nation for over 65 years! The Company is expanding in our territories and we are in immediate need of dedicated Benefits Representatives with ambitious goals. Requirements Excellent communication skills Basic computer knowledge Work ethics Outgoing, fun & energetic with an upbeat personality Accountability and coachability Time management skills Pass a criminal background check Benefits (after 90 days) Paid weekly ($70,000 - $75,000 1st year average) Bonuses Health Insurance Reimbursement Life Insurance Retirement Plan Requirements: Computer Cell phone (unlimited long distance calling) Access to Wifi Powered by JazzHR
    $24k-31k yearly est. 2d ago
  • Customer Service Rep - Remote

    American Income Life Insurance Company 4.2company rating

    California jobs

    (DUE TO COVID-19 IN EFFORT TO EMBRACE SOCIAL DISTANCING THE COMPANY OVERVIEW WILL BE CONDUCTED ONLINE VIA ZOOM) We are looking for an individual with great customer service skills for one of the main supplemental benefits companies in the nation for over 65 years! The Company is expanding in our territories and we are in immediate need of dedicated Benefits Representatives with ambitious goals. Requirements Excellent communication skills Basic computer knowledge Work ethics Outgoing, fun & energetic with an upbeat personality Accountability and coachability Time management skills Pass a criminal background check Benefits (after 90 days) Paid weekly ($70,000 - $75,000 1st year average) Bonuses Health Insurance Reimbursement Life Insurance Retirement Plan Requirements: Computer Cell phone (unlimited long distance calling) Access to Wifi Powered by JazzHR
    $28k-36k yearly est. 2d ago
  • Customer Support Specialist

    Blue Cross & Blue Shield of Mississippi 4.3company rating

    Gulfport, MS jobs

    **This role is 100% onsite in Flowood, MS. There is no remote capacity.** The Customer Support Specialist (CSS) is accountable for providing quality service to customers seeking direction, information or assistance by conducting effective research on matters related to my Blue, pharmacy, enrollment, billing, benefits and claims inquiries to ensure first call resolution is achieved. This position is responsible for ensuring a connection is made with each customer interaction to assist the customer with their initial concern and provide information tailored to their individual healthcare needs. Job-Specific Requirements: Must have a Bachelor's degree with at least a 3.0 GPA. Must have proficient computer skills and be able to successfully complete all levels of the call center training program. Excellent active listening skills in order to clearly understand members' issues. Must possess excellent communication skills to ensure a professional company image is projected at all times. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.
    $31k-42k yearly est. 2d ago
  • Pharmacy Services Specialist (Clinical Programs - Stars)

    Caloptima 4.6company rating

    Orange, CA jobs

    Pharmacy Services Specialist (Clinical Programs ‐ Stars) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Pharmacy Services Specialist (Clinical Programs ‐ Stars) and help shape the future of healthcare where you'll be an integral part of our Pharmacy Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Telework. If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum. You will utilize specialized pharmacy knowledge and expertise to assist participating pharmacies, members, providers, CalOptima Health departments, health networks and other entities in assuring the efficient, timely and effective provision of pharmaceutical products and services to CalOptima Health members. You will interact with other department staff throughout the organization, as well as external contacts daily. You will be responsible for ongoing public contacts including, but are not limited to, members, individual pharmacies, member advocates, family members, health networks, Public Guardian's Office, Regional Center and other agencies. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 85% ‐ Program Support Participates in a mission‐driven culture of high‐quality performance, with a member focus on customer service, consistency, dignity and accountability. Conducts outbound calls to members, pharmacies, and providers in an effort to improve Star measure performance for medication adherence and other Star programs as needed. Using a pharmacy computer program, retrieves drug‐specific technical data and information necessary for the completion of departmental and interdepartmental pharmacy‐related functions and operations. Assists with resolution of provider and member pharmacy issues requiring specialized technical and professional knowledge and expertise, including pharmacy authorizations. Supports the department with claims disputes between providing pharmacies, the pharmacy claims administrator, CalOptima Health Claims Department and other entities as necessary. Interprets and articulates Pharmacy Management program policies and procedures to pharmacy providers, other providers, other CalOptima Health staff, external agencies and others as required. Assists in the processing of pharmaceutical prior authorization and appeals requests as per the CalOptima Health Prior Authorization Guidelines as needed. Establishes and maintains key contacts both internally and externally to assure appropriate coordination and provision of pharmacy services to CalOptima Health Members. Accepts referrals from Member Services and work in conjunction with employees from this department to resolve all pharmacy‐related member complaints, including those related to the pharmacy authorization process. Assists pharmacies and health plans in resolving member‐specific pharmacy services access issues, removing barriers to access to pharmaceutical services. Identifies pharmacy‐related resources and recommend new procedures, processes or activities that help assure the efficient provision of pharmacy services to members. 10% ‐ Administrative Support Assists the team in carrying out department responsibilities and collaborates with others to support short‐ and long‐term goals/priorities for the department. Maintains documentation of the Stars adherence program and other Stars program outreach according to the internal guidelines. 5% ‐ Completes other projects and duties as assigned. Do You Have What the Role Requires? High School diploma or equivalent PLUS 1 year of experience as a pharmacy technician required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. You'll Stand Out More If You Possess the Following: Associate degree in a health‐related field. Pharmacy Technician Certification Board (PTCB). Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese). What the Regulatory Agencies Need You to Possess? A current, valid, unrestricted California Pharmacy Technician license required. Your Knowledge & Abilities to Bring to this Role: Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. Work independently and exercise sound judgment. Communicate clearly and concisely, both orally and in writing. Work a flexible schedule; available to participate in evening and weekend events. Organize, be analytical, problem‐solve and possess project management skills. Work in a fast‐paced environment and in an efficient manner. Manage multiple projects and identify opportunities for internal and external collaboration. Motivate and lead multi‐program teams and external committees/coalitions. Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Your Physical Requirements (With or Without Accommodations): Ability to visually read information from computer screens, forms and other printed materials and information. Ability to speak (enunciate) clearly in conversation and general communication. Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face‐to‐face interactions. Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting. Lifting and moving objects, patients and/or equipment 10 to 25 pounds Ways We Are Here For You You'll enjoy competitive compensation for this role. Our current hiring range is: Pay Grade: 301 ‐ $47,840 ‐ $64,584 ($23.00 ‐ $31.0500).
    $47.8k-64.6k yearly 2d ago
  • Customer Support Specialist

    Blue Cross & Blue Shield of Mississippi 4.3company rating

    Jackson, MS jobs

    **This role is 100% onsite in Flowood, MS. There is no remote capacity.** The Customer Support Specialist (CSS) is accountable for providing quality service to customers seeking direction, information or assistance by conducting effective research on matters related to my Blue, pharmacy, enrollment, billing, benefits and claims inquiries to ensure first call resolution is achieved. This position is responsible for ensuring a connection is made with each customer interaction to assist the customer with their initial concern and provide information tailored to their individual healthcare needs. Job-Specific Requirements: Must have a Bachelor's degree with at least a 3.0 GPA. Must have proficient computer skills and be able to successfully complete all levels of the call center training program. Excellent active listening skills in order to clearly understand members' issues. Must possess excellent communication skills to ensure a professional company image is projected at all times. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.
    $31k-40k yearly est. 2d ago
  • Customer Support Specialist

    Blue Cross & Blue Shield of Mississippi 4.3company rating

    Meridian, MS jobs

    **This role is 100% onsite in Flowood, MS. There is no remote capacity.** The Customer Support Specialist (CSS) is accountable for providing quality service to customers seeking direction, information or assistance by conducting effective research on matters related to my Blue, pharmacy, enrollment, billing, benefits and claims inquiries to ensure first call resolution is achieved. This position is responsible for ensuring a connection is made with each customer interaction to assist the customer with their initial concern and provide information tailored to their individual healthcare needs. Job-Specific Requirements: Must have a Bachelor's degree with at least a 3.0 GPA. Must have proficient computer skills and be able to successfully complete all levels of the call center training program. Excellent active listening skills in order to clearly understand members' issues. Must possess excellent communication skills to ensure a professional company image is projected at all times. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.
    $30k-40k yearly est. 2d ago
  • Customer Support Specialist

    Blue Cross & Blue Shield of Mississippi 4.3company rating

    Hattiesburg, MS jobs

    **This role is 100% onsite in Flowood, MS. There is no remote capacity.** The Customer Support Specialist (CSS) is accountable for providing quality service to customers seeking direction, information or assistance by conducting effective research on matters related to my Blue, pharmacy, enrollment, billing, benefits and claims inquiries to ensure first call resolution is achieved. This position is responsible for ensuring a connection is made with each customer interaction to assist the customer with their initial concern and provide information tailored to their individual healthcare needs. Job-Specific Requirements: Must have a Bachelor's degree with at least a 3.0 GPA. Must have proficient computer skills and be able to successfully complete all levels of the call center training program. Excellent active listening skills in order to clearly understand members' issues. Must possess excellent communication skills to ensure a professional company image is projected at all times. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.
    $31k-41k yearly est. 2d ago
  • Customer Service Representative

    The Phoenix Group 4.8company rating

    Los Angeles, CA jobs

    We are seeking a Workplace Experience team member to provide exceptional service and operational support across multiple areas of the office. This role plays a central part in creating a seamless and welcoming environment for employees and guests alike. Responsibilities span from front desk and meeting space coordination to travel support and urgent communication needs. Responsibilities Create a welcoming and polished experience for employees, clients, and guests. Deliver responsive, high-touch customer service in person, by phone, and through digital channels. Collaborate with teammates to share responsibilities and maintain seamless operations. Partner with other departments to direct inquiries and resolve issues efficiently. Serve as a local resource for workplace requests, ensuring smooth handling of needs ranging from logistics to event coordination. Safeguard sensitive and confidential information with the highest level of discretion. Qualifications At least 3+ years of relevant work experience Excellent phone etiquette and excellent verbal, written, and interpersonal skills Ability to multi-task, organize, and prioritize work A customer-first mindset, with the ability to handle requests thoughtfully and professionally. Initiative and sound judgment to manage situations independently when needed.
    $33k-43k yearly est. 2d ago
  • Senior Customer Service Representative

    Brightway Insurance 4.4company rating

    Boca Raton, FL jobs

    The Senior Customer Service Representative supports the daily operations of the agency by providing advanced customer service, policy support, and account management. This role acts as a primary point of contact for clients, resolves complex inquiries, assists with policy changes, and ensures exceptional service delivery while maintaining compliance with state and carrier requirements. Client Service & Support Serve as the main contact for policyholders, delivering high-quality service via phone, email, and in-person interactions. Handle complex customer inquiries related to coverage, billing, claims, renewals, and endorsements. Assist clients with policy changes, cancellations, reinstatements, and general account updates. Review client accounts to ensure accuracy and identify gaps in coverage or service needs. Policy Administration Process endorsements, certificates of insurance, evidence of insurance, bind requests, and other policy documentation. Support new business and renewal processes by gathering required information and preparing applications. Verify policy accuracy, rating information, and carrier guidelines prior to final processing. Coordinate with insurance carriers on underwriting requirements, coverage questions, and policy adjustments. Claims Support Guide clients through the claims filing process and provide follow-up as needed. Act as a liaison between carriers, adjusters, and policyholders to ensure timely updates. Team & Operational Support Provide guidance and support to junior CSRs and team members. Assist in workflow improvement, procedure updates, and best-practice implementation. Maintain compliance with all state regulations, company policies, and carrier requirements. Customer Experience & Retention Build strong client relationships through responsive service and proactive communication. Identify opportunities for cross-selling or up-selling appropriate P&C products (within 4-40 license permissions). Support retention efforts by reviewing renewal options and assisting in remarketing when needed. Required Qualifications Valid Florida 4-40 Customer Representative License. 3-5+ years of customer service or account management experience in a Property & Casualty insurance environment. Strong knowledge of personal lines and/or commercial lines insurance products, coverage forms, and terminology. Proficiency with insurance management systems (e.g., Applied Epic, AMS360, QQ, Hawksoft) preferred. Excellent communication, problem-solving, and organizational skills. Ability to work independently, prioritize tasks, and manage high-volume workloads.
    $33k-38k yearly est. 2d ago
  • Client Services Representative

    Venbrook 3.3company rating

    Irvine, CA jobs

    JOB TITLE: Client Services Representative (CSR) - Employee Benefits DEPARTMENT: Employee Benefits CLASSIFICATION: Non-Exempt LANGUAGE REQUIREMENT: Bilingual English and Spanish COMPENSATION: Hourly wage: $28.85 - $33.65 Based on experience COMPANY OVERVIEW: Venbrook is a privately held insurance brokerage and risk management firm providing tailored solutions across employee benefits, property and casualty, and specialty lines. Our teams support clients through direct service, accountability, and clear communication. Our culture emphasizes ownership, collaboration, and trust. We offer a comprehensive benefits package: 401k with employer match Medical, dental, vision, life, and disability insurance Paid Time Off Paid holidays Paid sick leave Professional development opportunities Flexible work arrangements JOB SUMMARY: The Client Services Representative supports employees and HR contacts with day-to-day benefit inquiries. You operate in a high-volume, member-facing environment. You resolve routine issues and escalate complex matters following defined guidelines. Your work supports a consistent member experience and reduces service interruptions for Account Management teams. DUTIES/RESPONSIBILITIES: Employee and Member Support Serve as the primary contact for benefit inquiries via phone and email Explain coverage, eligibility, and benefit usage in clear terms Guide members through carrier portals, mobile applications, and ID card access Support employees during open enrollment Provide bilingual support in English and Spanish Routine Benefits and Claims Support Process ID card requests and replacements Confirm provider network participation Respond to basic claim status inquiries Verify eligibility and enrollment changes Add or remove dependents Provide prescription refill guidance Address standard open enrollment questions Issue Identification and Escalation Identify issues requiring escalation Route cases to Account Management per internal guidelines Ensure complete documentation prior to escalation Maintain ownership until successful handoff is confirmed Documentation and Collaboration Document all interactions and outcomes in the CRM system Track open items through resolution Partner with Account Managers and Advocacy teams Identify recurring issues and share trends with leadership EDUCATION & EXPERIENCE: Required Skills & Qualifications · One to three years of experience in employee benefits, insurance · Bilingual English and Spanish · Clear written and verbal communication skills · Ability to manage high call and email volume · Strong organization and follow-through · Professional and composed in time-sensitive situations Preferred Qualifications · Experience in an employee benefits brokerage or consulting environment · Knowledge of health and welfare benefit plans · Experience with CRM or benefits administration platforms · Working knowledge of Outlook, Word, and Excel Measures of Success Timely resolution of routine member issues Clear and complete escalation documentation Positive member experience feedback Reduced disruption to Account Management workflows
    $28.9-33.7 hourly 2d ago
  • Customer Support Specialist

    Blue Cross & Blue Shield of Mississippi 4.3company rating

    Tupelo, MS jobs

    **This role is 100% onsite in Flowood, MS. There is no remote capacity.** The Customer Support Specialist (CSS) is accountable for providing quality service to customers seeking direction, information or assistance by conducting effective research on matters related to my Blue, pharmacy, enrollment, billing, benefits and claims inquiries to ensure first call resolution is achieved. This position is responsible for ensuring a connection is made with each customer interaction to assist the customer with their initial concern and provide information tailored to their individual healthcare needs. Job-Specific Requirements: Must have a Bachelor's degree with at least a 3.0 GPA. Must have proficient computer skills and be able to successfully complete all levels of the call center training program. Excellent active listening skills in order to clearly understand members' issues. Must possess excellent communication skills to ensure a professional company image is projected at all times. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.
    $30k-38k yearly est. 2d ago
  • Customer Support Specialist

    Blue Cross & Blue Shield of Mississippi 4.3company rating

    Southaven, MS jobs

    **This role is 100% onsite in Flowood, MS. There is no remote capacity.** The Customer Support Specialist (CSS) is accountable for providing quality service to customers seeking direction, information or assistance by conducting effective research on matters related to my Blue, pharmacy, enrollment, billing, benefits and claims inquiries to ensure first call resolution is achieved. This position is responsible for ensuring a connection is made with each customer interaction to assist the customer with their initial concern and provide information tailored to their individual healthcare needs. Job-Specific Requirements: Must have a Bachelor's degree with at least a 3.0 GPA. Must have proficient computer skills and be able to successfully complete all levels of the call center training program. Excellent active listening skills in order to clearly understand members' issues. Must possess excellent communication skills to ensure a professional company image is projected at all times. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.
    $30k-38k yearly est. 2d ago
  • Community Based Services Specialist

    Santa Clara Family Health Plan 4.2company rating

    San Jose, CA jobs

    Salary Range: $74,557 - $111,835 The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change. FLSA Status:Non-exempt Department:Community Based Programs Reports To:Manager, SDOH or Manager, Community Based Case Management Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521 GENERAL DESCRIPTION OF POSITION The Community Based Services Specialist serves as the lead, primary contact, and liaison for developing, supporting and monitoring the network of public and community based providers and vendors delivering Enhanced Care Management (ECM), Community Supports (CS), and/or other activities, programs or special projects addressing social determinants of health. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below. Develop and maintain updated knowledge of community based services, and capacity across Santa Clara County and support identification and assessment of ECM and/or CS provider network gaps. Recommend for initial and ongoing needs to support ECM and/or CS delivery system and operational infrastructure including data exchange, workforce training and capacity building. Support ECM and/or CS authorization and delivery process in accordance with DHCS-developed service definitions, eligibility criteria and reporting requirements. Oversee the development and management of the ECM, SDOH and/or CS provider network including: Serve as a knowledge and resource expert for ECM, CS and/or SDOH provider network operations. Establish and manage positive and productive working relationships with all public and community-based providers and vendors delivering services to members under ECM, CS or SDOH projects. Receive, research and respond to inquiries and issues that are raised by or impacting providers in a timely fashion and in collaboration with appropriate business units. Proactively communicate and collaborate with providers to identify problem patterns, track and trend issues, prepare recommendations for potential service improvement opportunities and develop tools and processes to improve communication and other processes Oversee collaboration with internal business units, particularly Provider Network Operations, Health Services Department, Finance and Claims, regarding provider communication, training and support and to ensure payments are made in accordance with vendor agreement terms. Schedule, conduct and report on regular site visits with each provider as required and coordinate and host at least one annual meeting with providers. Conduct orientation and ongoing training and education to community service providers and office staff including technical assistance, development of presentations and other written guidance or materials, in-person sessions, webinars and/or calls as needed. Assist in the preparation of promotional materials for the public, website or newsletters. Oversee provider compliance with required ECM and/or CS trainings and technical assistance including in-person sessions, webinars, and/or calls as necessary. Establish and oversee a program for communicating and tracking ECM and/or CS provider compliance with vendor agreement scope of work, key operational and financial objectives, and quality and performance metrics. Maintain accurate and timely documentation of provider contacts in compliance with NCQA standards, DHCS, DMHC and CMS regulatory requirements. Contribute to the development of ECM and/or CS pricing including recommending changes in pricing subsystems. Support the Department Manager in generating reports and performing special projects. Troubleshoot with providers to address issues related to submission of claims and encounter data for ECM and/or CS services. Understand and track applicable regulatory and reporting requirements. Ensure accuracy and regulatory compliance for all materials or documents. Attend off-site meeting or events as necessary. Perform other related duties as required or assigned. REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired. Bachelor's Degree in public health, social welfare or related field; or equivalent experience, training, or coursework. (R) Minimum two years of progressively responsible and direct work experience working with the essential duties and responsibilities described above. (R) Demonstrated experience leading/managing projects, initiatives, and/or leading or directing the work of others. (R) Knowledgeable in the field of home and community-based services and community resource networks and a particular interest in working to address health disparities and addressing the needs of low-income communities. A deep understanding of SDOH that impact Santa Clara County and community members. (R) Ability to think creatively and work strategically, to help develop and implement innovative solutions yielding measurable results to the organization. (R) Ability to think creatively and strategically, gather and analyze data, organize and write reports, organize work efficiently. (R) Ability to understand, interpret, and apply applicable rules and regulations, and establish and evaluate priorities. (R) Advanced working knowledge and proficient with Microsoft Suite applications, and the ability to operate all applicable software. (R) Excellent oral and written communication skills, including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments and outside entities over the telephone, in person or in writing.(R) Ability to effectively facilitate meetings and deliver information/presentations to management, regulators, or staff (R). Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) Ability to take initiative and exercise good judgment when making decisions within the scope of the position. (R) Ability to comply with all SCFHP policies and procedures. (R) Ability to perform the job safely with respect to others, to property, and to individual safety. (R) Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. (R) Knowledge of the community-based delivery system and managed care. (D) Project Management Professional (PMP) certification (D) WORKING CONDITIONS Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to regular contact with co-workers, managers, external partners, and vendors, in person, by telephone, and via work-related electronic communications. PHYSICAL REQUIREMENTS Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation: Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R) Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R) Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R) Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R) Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R) Reasoning Requirements:ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person, by telephone, and electronically, throughout a typical workday; attention to detail. (R) ENVIRONMENTAL CONDITIONS General office conditions. May be exposed to moderate noise levels. EOE (function () { 'use strict'; social Share.init(); })();
    $74.6k-111.8k yearly 2d ago
  • Customer Service Representative (4-40 needed)

    Brightway Insurance 4.4company rating

    Jacksonville, FL jobs

    Brightway Insurance is a leading property and casualty insurance distribution company with over 300 franchise locations in 35 states. We pride ourselves on delivering exceptional customer experiences and empowering our agents with innovative tools and support. We are currently seeking Customer Service Representative (CSR) to join our team Position Summary: As a CSR, you will play a key role in ensuring our clients receive excellent service and support. You'll assist both new and existing customers by answering questions, processing changes to policies, handling billing inquiries, and supporting sales efforts when needed. Responsibilities: Provide exceptional customer service to policyholders via phone, email, and in-person interactions Assist clients with policy changes, billing inquiries, claims, and general insurance questions Educate clients on available coverages, products, and discounts Maintain accurate records in our CRM and carrier systems Collaborate with agents and producers to ensure a seamless customer experience Support retention efforts by identifying opportunities for cross-selling and upselling Qualifications: High school diploma or equivalent required; college degree a plus 4-40 Customer Service License required 1+ years of experience in insurance or a customer service-related role preferred Strong communication and interpersonal skills Detail-oriented with excellent organizational abilities Proficient in Microsoft Office Suite and comfortable learning new software Why Join Us? Competitive salary plus performance bonuses Opportunities for career growth and professional development Supportive team environment Work that makes a difference in people's lives
    $27k-33k yearly est. 2d ago
  • Bilingual English and Japanese Customer Service Representative

    Unitedhealth Group 4.6company rating

    Tampa, FL jobs

    $1000 Sign-On Bonus for External Candidates This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Imagine being able to get answers to your health plan questions from someone who speaks the same language as you do.Or, the opposite, not being able to get the answers.At UnitedHealth Group, we want our customers to get those answers by speaking to one of our Bilingual Representatives.If you're fluent in English and Japanese, we can show you how to put all of your skills, your passions and your energy to work in a fast - growing environment. At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Customer Service Representative is responsible for handling all incoming Billing, Eligibility, benefits, claims, appeals and grievances calls, chat, e-mails and serving as the primary point of contact for departmental inquiries. This role provides expertise and customer service support to members, customers, and / or international providers through direct phone - based interactions, resolving a wide range of inquiries. This position is full time (40 hours / week). Employees must be willing to work any shift in a 24 / 7 department, including weekends, holidays, and occasional overtime based on business needs. We provide 12 weeks of paid training, which is mandatory (no PTO during this period). The hours during training will be 8:00am - 4:30 pm EST from Monday - Friday. After training is complete, your assigned shift will remain fixed. Training will be conducted virtually from your home. Primary Responsibilities: Ensures quality customer service for internal and external customers Responds to incoming customer service requests, both verbal and written (calls, emails, chats) Places outgoing phone calls to complete follow - up on customer service requests as necessary Identifies and assesses customers' needs quickly and accurately Solves problems systematically, using sound business judgment Partners with other billing and eligibility department representatives to resolve complex customer service inquiries Monitors delegated customer service issues to ensure timely and accurate resolution Applies appropriate communication techniques when responding to customers, particularly in stressful situations Informs and educates new customers regarding billing / invoicing set up and billing / payment procedures Addresses special (ad - hoc) projects as appropriate You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: High School Diploma / GED OR equivalent work experience Must be 18 years of age OR older 1+ years of customer service experience with analyzing and solving customer problems 1+ years of experience with Windows personal computer applications which includes the ability to learn new and complex computer system applications Bilingual fluency in English and Japanese Must be willing to work any shift in a 24 / 7 department, including the flexibility to work weekends, holidays, and occasional overtime based on business needs Preferred Qualifications: 2+ years of customer service experience in a call center environment Experience in the healthcare industry Telecommuting Requirements: Ability to keep all company sensitive documents secure (if applicable) Required to have a dedicated work area established that is separated from other living areas and provides information privacy Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service (UHG requires a wired internet connection: cable, DSL, or fiber internet service with upload and download speeds suitable for the role and approved by operations. Minimum speed standard is 20mbps download / 5mbps upload. Wireless service such as satellite, hot spot, line of sight antenna cannot be used for telecommuting.) Soft Skills: Comfortable with communicating via email, chat, and phone calls to provide support and resolve inquiries Understanding customer concerns accurately and responding appropriately Using sound judgment to resolve issues systematically *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RED
    $17.7-31.6 hourly 3d ago
  • Customer Service Lead

    The Phoenix Group 4.8company rating

    Los Angeles, CA jobs

    Key Responsibilities Deliver high-quality customer service and administrative support using a customer interaction platform for workplace-related needs, including reception services, facilities support, hosting, conference room coordination, emergency notifications, and travel assistance Design and elevate workplace experiences that make employees, clients, and guests feel welcomed, valued, and connected to the organization Provide polished, high-touch service to all visitors and external guests Assign, monitor, and coordinate work across a 24/7 team to ensure timely and accurate completion of requests Train and support team members on established processes, tools, and workflows Foster a collaborative team environment where ownership and accountability are shared across all agents Safeguard confidential, sensitive, privileged, financial, and proprietary information at all times Qualifications We're interested in candidates who: Communicate clearly and professionally, both verbally and in writing Consistently deliver exceptional customer service and take pride in exceeding expectations Demonstrate sound judgment and the ability to assess situations and take initiative independently Has had previous management or lead experience in a customer support role And who have: A high school diploma or equivalent At least three (3) years of experience in workplace services, reception, hospitality, technology support, or an inbound customer service environment Administrative experience, preferably within a professional services or corporate setting The Phoenix Group Advisors is an equal opportunity employer. We are committed to creating a diverse and inclusive workplace and prohibit discrimination and harassment of any kind based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. We strive to attract talented individuals from all backgrounds and provide equal employment opportunities to all employees and applicants for employment.
    $36k-46k yearly est. 1d ago
  • Client Concierge/Client Specialist

    Brightway Insurance 4.4company rating

    Palm Valley, FL jobs

    Brightway Insurance is hiring a Full-Time Client Concierge in PVB As a Client Concierge you will be the first point of contact for our clients, providing them with exceptional service and support. You will play a crucial role in maintaining our agency's reputation for excellence and ensuring client satisfaction. Key Responsibilities Greet and assist clients in person, via phone, email, and live chat, addressing inquiries and providing information on insurance products and services. Assist clients with policy changes, renewals, and claims, ensuring timely and accurate processing. Collaborate with the sales team to identify client needs and recommend appropriate insurance solutions. Maintain organized client records, process paperwork, and manage scheduling to support agency operations. Follow up with clients to ensure satisfaction and encourage policy renewals and referrals. Qualifications High school diploma or equivalent; college degree preferred. Previous experience in customer service, insurance, or administrative roles is advantageous. Strong communication, organizational, and multitasking abilities; proficiency in Microsoft Office Suite and CRM software. Possession of a 4-40 Customer Representative license is preferred or the willingness to obtain one. Established in 2008, Brightway Insurance has grown to become one of the largest privately-owned property and casualty insurance distribution companies in the U.S., with more than 350 agencies across 38 states and over $1.4 billion in annual premiums. Our unique franchise model offers agents the opportunity to focus on sales while we handle back-office operations, including carrier relations, licensing, and marketing support. This approach allows our agents to maximize their sales efforts and build lasting client relationships. If you're an ambitious and driven individual eager to advance in the thriving insurance industry, Brightway Insurance offers the perfect opportunity. Take the next step in your career as a Client Concierge-apply today!
    $34k-56k yearly est. 5d ago

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