Member Services

Orange, CA 92868

Employment Type: Contract Job Category: Medical Customer Service Job Number: 46958 Pay Rate: 17

Are you passionate about healthcare and care about people s needs? Would you like to work for a company in Orange that has successfully supported its members and management for more than 30 years?

Immediate openings are available for Member Service Representatives to assist with open enrollment for Medicare Advantage based in their central Orange County office. Fun environment with staff events, employee performance recognition programs, promotion potential in a variety of departments, and fantastic benefits!

Job Functions:

  • Act as an Ambassador for the company to their members
  • Direct calls from members, providers, pharmacy, service representatives and staff members
  • Explain benefits, procedures, and services to callers
  • Inform providers and employers about benefits and eligibility
  • Provide authorization for outpatient surgery and claims
  • Provide referral requests to other providers in our network
  • Process hospital admissions and pre-admit authorizations
  • Resolve eligibility problems, COBRA, claims & other coverage issues
  • Provide drug authorizations and confirm drug co-pays amounts
  • Resolve any prescription claims issues
  • Respond to correspondence related to claims and file
  • Build rapport with members to ensure satisfaction and retention

Special Talents:

  • Incredible listening and problem-solving skills
  • Excellent verbal and written communication skills
  • Ability to organize and prioritize customer needs


  • 2+ Years of prior call center experience
  • 6+ months of healthcare experience preferred
  • High school diploma required
  • Associates or Bachelors degree preferred

Apply today!

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