Non-Clinical - Administrative - Customer Service Representative

22nd Century Technologies, Inc.

Los Angeles, CA(remote)

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JOB DETAILS

SKILLS

Administrative Skills, Call Volume, Communication Skills, Communications Protocols, Computer Skills, Computer Systems, Customer Relationship Management (CRM) Systems, Customer Service Evaluation, Customer Support/Service, Data Entry, Detail Oriented, Documentation Format, Epic Systems, Epic Tapestry, HIPAA (Health Insurance Portability and Accountability Act), Health Education, Health Plan, Health Plan Membership, Healthcare, Healthcare Customer Service, Healthcare Providers, High School Diploma, Identify Issues, Maintain Compliance, Managed Care, Management of Information Systems/Technology (MIS), Microsoft Office, Multitasking, Organizational Skills, Presentation/Verbal Skills, Problem Solving Skills, Process Improvement, Quality Assurance, Quality Management, Quality Metrics, Record Keeping, Regulations, Scripting (Scripting Languages), Service Delivery, Support Documentation, Team Player, Time Management, Work From Home, Writing Skills

LOCATION

Los Angeles, CA

POSTED

10 days ago

Member Services Agent
Shift: M-F 8-5 PST
Location: Remote (Must have prior experience working remotely)

Position Summary

The Member Services Agent serves as the primary point of contact for members and patients, providing exceptional customer service, education, and issue resolution. This role handles inbound calls, documents member interactions, assists with healthcare-related inquiries, and collaborates with internal departments to ensure timely and effective service.

Required Qualifications
" High School Diploma, GED, or equivalent.
" Minimum of 3 years of customer service, member services, or related experience in a healthcare environment.
" The position requires strong verbal and written communication skills, including professional email etiquette, proper grammar, accurate documentation, clear formatting and attention to detail
" The role requires documenting research, call outcomes, discrepancies, and next steps in a clear, organized, and audit-ready manner.
" Knowledge of healthcare terminology and managed care principles.
" Ability to handle sensitive situations with empathy, professionalism, and confidentiality.
" Strong problem-solving, organizational, and multitasking skills.
" Proficiency with computer systems, Microsoft Office applications, and data entry.
" Ability to work effectively in a fast-paced environment with high call volumes, interruptions, and changing priorities.
" Ability to collaborate as part of a team and provide cross-coverage as needed.
" Ability to work standard business hours (8:00 AM 5:00 PM PST) and occasional overtime when required.

Key Responsibilities
Member Support & Customer Service
" Answer and manage inbound member and patient calls with professionalism, empathy, and excellent customer service.
" Educate members regarding healthcare benefits, coverage, eligibility, referrals, authorizations, provider networks, claims, and member rights and responsibilities.
" Research, troubleshoot, and resolve member issues, escalating complex concerns when appropriate.
" Facilitate warm transfers and coordinate with internal departments to ensure seamless service.
" Conduct follow-up communication and callbacks to ensure issue resolution and member satisfaction.
" Serve as a liaison between members, patients, providers, and contracted health plans as needed.
Documentation & Administrative Support
" Accurately document all member interactions, requests, updates, and resolutions in the managed care information system.
" Maintain accurate records and process department-assigned requests in accordance with established protocols.
" Utilize departmental resources, systems, and tools to support service delivery and productivity goals.
" Adhere to call handling standards, customer service protocols, and approved communication scripts.
Compliance & Quality
" Maintain compliance with HIPAA, confidentiality requirements, and all applicable healthcare regulations.
" Support departmental quality improvement initiatives and recommend process improvements when appropriate.
" Monitor and contribute to achieving customer service, quality, and productivity metrics.
" Uphold UCLA Health service standards, patient experience expectations, and workplace conduct policies.
Preferred Qualifications
" Experience with EPIC Tapestry, CRM systems, or similar healthcare technology platforms.
" Experience working in managed care, health plans, or healthcare customer service environments.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

About the Company

22nd Century Technologies, Inc.

22nd Century Technologies, Inc., is one of the fastest growing IT Service Integrator and Workforce Solution companies in the United States. Founded in 1997, 22nd Century Technologies is a Certified National Minority Business Enterprise with 6,000+ people including 600+ Cyber SMEs nationwide supporting our customers in all 50 states, Canada, and Mexico. With HQs in Somerset, NJ and Mclean, VA, 22nd Century has 14 offices throughout the United States. As part of our unrelenting focus on quality and compliance, 22nd Century Technologies’ delivery is based on Certified Matured Processes including CMMI L3 Dev & SVC, ISO 20000, ISO 27001, and ISO 9001 quality processes. With a strong focus on the public sector, 22nd Century currently holds government contracts with 14 out of 15 Federal Executive agencies including DoD, 37 other Federal agencies, 50 States, 115+ Local agencies, and 37 School Districts. In the last three years, we have expanded our services to Fortune 500 and other commercial clients and currently support 80+ commercial clients.

Recognized among “Best Company to Work For” by Forbes, 22nd Century Technologies, Inc., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

COMPANY SIZE

100 to 499 employees

INDUSTRY

Computer/IT Services

FOUNDED

1997

WEBSITE

https://www.tscti.com/careers-0

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