Job Description

Customer Care Team Member

The Customer Care team is responsible to service our members to experience the upmost of care and compassion by conveying empathy and resolving all issues and helping them get back to enjoying their lives as quickly and effortlessly as possible. The Correspondence Phone Support will report to the Operation Supervisor. In this role you will be responsible of upholding our mission of providing service worthy of our family and friends. You are empowered to provide members with peace of mind that their current issue is resolved and that none are on the horizon.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Responsibilities

Your Work

In this role, you will:

• Resolve incoming calls concerning member eligibility, benefits, provider information, and clinical needs
• Handle escalated calls
• Perform inventory reduction, routine to mid-level
• Expedite, research, and resolve complex issues
• Consistently perform established performance metrics including but not limited to voice of the customer survey results, quality, and production
• Coordinates membership changes such as member's primary care physician
• Participate in quality and efficiency workgroups to continuously improve quality member/customer satisfaction as requested
• Assist members with grievances and appeals
• Engage members with their wellness plan options
• Other duties as assigned

Qualifications

Your Knowledge and Experience

• Must reside in the state of CA preferably within a 50-mile radius from one of our office locations Long Beach, Rancho Cordova, Redding, Woodland Hills, Lodi, El Dorado Hills etc.
• Requires a High School Diploma or GED
• Typically, requires at least 3 years of prior relevant experience
• Basic understanding of medical terminology is preferred
• Basic understanding of the principles and protocols of Medi-Cal
• Customer service orientated
• Requires basic job knowledge of Microsoft Suite systems and the ability to use applications on a computer proficiently
• Requires attending and completing training facilitated remotely
• Requires high internet connectivity speed
• Requires private work location at their residence free from distractions and within 15 feet of their Wi-Fi modem

Preferred Qualifications

Bilingual Spanish. Language proficiency as demonstrated by successful completion of an oral language proficiency test

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

About Us

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities join us!

Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Job Info

• Job Identification 20261323
• Job Category Customer Services and Operations
• Locations US-CA-Long Beach-Kilroy Airport
• Pay Range for California $20.13 to $28.18
• Pay Range for Bay Area $22.69 to $31.76
• Role can be filled by a candidate requiring sponsorship No

Blue Shield of California

Job Tags

Full time, Part time, Work at office, Local area, Remote work, Work from home, Home office, 2 days per week

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