Customer Service Representative

Job Description

Job Description

We are looking for a Bilingual Korean/English Customer Service Representative to join a healthcare organization in Westminster, California on a Contract basis. This role supports members and prospective members by addressing pharmacy benefit questions, coordinating service needs, and delivering a high standard of assistance across phone-based interactions. The ideal candidate brings strong call center experience, accurate documentation skills, and a service-focused approach in a regulated healthcare environment.

Responsibilities:

• Respond to inbound member and prospective member inquiries related to pharmacy benefits, providing clear and accurate guidance.

• Coordinate refill support with participating pharmacies when members need assistance completing the process.

• Escalate medication-related or clinical issues to appropriate clinical leaders to ensure timely follow-up.

• Partner with internal performance and service teams to encourage medication adherence and support member outcomes.

• Take part in outbound and inbound calling initiatives assigned by leadership to improve member engagement and service delivery.

• Record each interaction thoroughly in the appropriate systems, including actions taken and any required follow-up steps.

• Adhere to established workflows, departmental procedures, and job aids while identifying opportunities to improve efficiency.

• Maintain compliance with applicable federal and state regulations as well as internal operational standards.

• Participate in training sessions, team meetings, and a feedback-driven environment focused on continuous improvement.

• Support additional service-related tasks and projects as needed by management.

• 2+ years of experience in customer service, preferably in a call center or healthcare support setting.
• Ability to manage inbound and outbound calls professionally while delivering excellent member service.
• Experience handling order entry or related transactional data with strong attention to detail.
• Strong written documentation skills for accurately recording member interactions and resolutions.
• Comfortable following defined policies, procedures, and compliance requirements in a regulated environment.
• Ability to recognize issues that require escalation and route them appropriately.
• Effective communication and interpersonal skills with a member-focused approach.
• Willingness to work in a coaching-oriented environment that emphasizes ongoing feedback and development.