Customer Service Representative

Job Description

Job Description

We are looking for a bilingual Mandarin/Cantonese Customer Service Representative to support members in a fast-paced healthcare environment in Westminster, California. This is a Contract position focused on delivering clear, compassionate assistance, resolving benefit and service questions, and guiding callers toward the best available solutions. The ideal candidate brings prior call center or customer support experience, communicates effectively with diverse populations, and can balance accuracy, empathy, and efficiency throughout each interaction.

Responsibilities:

• Respond to inbound member inquiries and evaluate each situation carefully to provide accurate guidance on benefits, coverage, and available plan choices.

• Investigate service concerns by gathering relevant details, explaining next steps, and ensuring members receive timely and complete resolution whenever possible.

• Route complex or sensitive issues to supervisors or partner departments when additional review or specialized support is needed.

• Take part in outbound calling initiatives and retention-focused outreach efforts assigned by leadership to strengthen member engagement.

• Maintain precise records of conversations, actions taken, and required follow-up in designated systems in accordance with departmental standards.

• Adhere to established operating procedures, job aids, and compliance expectations while identifying workflow issues and recommending practical improvements.

• Contribute to team effectiveness by participating in coaching sessions, staff meetings, and ongoing training activities.

• Support organizational and regulatory compliance by following applicable federal, state, and company guidelines in all member interactions.

• Perform additional customer service and administrative duties as needed to meet department goals.

• High school diploma or equivalent required; a bachelor’s degree or comparable relevant experience is preferred.
• At least 2 years of customer service experience, ideally within healthcare, health plan operations, or a call center environment.
• Working knowledge of healthcare regulations, including familiarity with Medicare and Medicaid-related guidelines, is preferred.
• Strong verbal and written communication skills with the ability to listen actively, explain solutions clearly, and de-escalate challenging conversations.
• Comfortable managing phone conversations while entering accurate information in real time and navigating multiple systems simultaneously.
• Proficiency with Microsoft Office applications, including Word, Excel, and Outlook.
• Typing speed of at least 40 words per minute required; 60 words per minute preferred.
• Ability to work some weekends from October through March; bilingual skills in languages such as Cantonese, Mandarin, Vietnamese, Korean, Spanish, Thai, Khmer, or Japanese may be beneficial or required.