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Customer Service - Eligibility
Customer Service - Eligibility-July 2024
Orange
Jul 8, 2025
About Customer Service - Eligibility

  Description

  Kforce client is seeking a Customer Service Representative with Medi-Cal eligibility experience in Orange, CA.Responsibilities: Customer Service Representative will maintain eligibility accuracy through daily monitoring, updating, and reviewing of the current Medi-Cal program requirements, and must have some specialized background or knowledge relevant to Medi-Cal Assist with completing various members requests such as Change of Health Network Requests, PCP Change requests, and Data correction forms Respond to questions, interpret policies, and regulations Develops materials (e.g., letters/surveys, etc.) and coordinate data files to arrange for mail merge of materials as applicable As a Customer Service Representative, you will prepare reports and create reporting tools; Performs special reconciliation procedures, including Excel sorts and mergers, filters and compiling reports, and Access database procedures Act as liaison between the Enrollment department and other Customer Service staff

  Requirements

  High School diploma or equivalent required 1+ years of experience with Medi-Cal eligibility experience required Health insurance experience (Medi-Cal) preferred Prior experience interacting with regulatory agencies, including Department Health Care Services (DHCS) and Department of Managed Health Care (DMHC), and practices related to Medi-Cal is also preferred Experience in a Health Maintenance Organization (HMO), managed care or Medi-Cal setting is preferred Bilingual (Spanish, Vietnamese, Arabic, Farsi, Korean, Chinese) is strongly preferred Customer Service experience is strongly preferred

  The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

  We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

  Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless and until paid and may be modified in its discretion consistent with the law.

  This job is not eligible for bonuses, incentives or commissions.

  Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

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