Customer Service Representative

Job Description

Job Description

We are looking for a Customer Service Representative to support member enrollment operations for a healthcare organization in Huntington Beach, California. This Long-term Contract opportunity is ideal for someone who enjoys helping customers, managing detailed information, and ensuring accurate member records. In this role, you will assist with enrollment-related questions, process eligibility updates, and work across internal teams to deliver a smooth and timely experience for new and existing members.

Responsibilities:

• Provide prompt support to members, clients, and internal partners by handling enrollment-related questions through phone, email, and other service channels.

• Review applications and enter enrollment information into company systems with a high level of accuracy and attention to detail.

• Process new enrollments, disenrollments, and eligibility updates while ensuring all records remain current and complete.

• Investigate rejected transactions and coordinate with team members to resolve discrepancies affecting member enrollment status.

• Confirm coverage and enrollment details with clients and respond to issues involving claims, tracking records, or account updates.

• Maintain organized documentation within eligibility and enrollment databases to support compliance and operational accuracy.

• Perform routine file reconciliations on a daily and monthly basis to identify mismatches and correct data issues.

• Compare submitted information against source documents to validate completeness, accuracy, and proper system entry.

• Collaborate with colleagues to resolve exception cases and take timely action to ensure members are enrolled correctly.

• Associate degree or an equivalent combination of education and relevant work experience.
• At least 2 years of customer service or enrollment support experience, preferably in healthcare or managed care settings.
• Previous experience with data entry, order entry, and Microsoft Office applications, including Excel and Word.
• Ability to navigate multiple computer systems while entering and retrieving information efficiently and accurately.
• Strong attention to detail, organization, and follow-through when managing records and member data.
• Clear communication skills with the ability to respond effectively to inbound and outbound customer inquiries.
• Familiarity with Medicare guidelines or Medicare Managed Care processes is preferred.
• Ability to interpret written procedures, adapt to change, and maintain high service standards in a fast-paced environment.