Health Plan Customer Service Associate

Job Title

Handles incoming calls from plan members and healthcare providers for the health plans. Provides information as needed for questions related to medical, dental, vision claims based upon the benefit descriptions. Provides communication, information, assistance and coordination for all customer requests.

Job Description

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Requirements

Education and Work Experience:

• High School Education/GED or equivalent: Preferred
• Associate's/Technical Degree or equivalent combination of education/related experience: Preferred
• Two years' experience in customer service and or health plan customer service experience: Preferred

Essential Functions

• Provides information as needed for questions related to medical, dental and vision claims.
• Serves as the subject matter expert for the benefit descriptions, claims payment process and plan provisions.
• Receives, processes, and distributes all types of incoming mail. Properly records incoming checks. Manages filing systems for incoming, outgoing and processed mail. Pulls files/claims as needed for staff. Prepares bills to be sent for review.
• Maintains basic knowledge of claims software system.
• Prepares general documents. Completes copywork as requested. Retrieves files. Requests equipment service. Provides relief receptionist coverage. Delivers, distributes and assists with maintenance of supplies.
• Performs other job-related duties as assigned.

Organizational Requirements

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. Visit for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.