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Community Resource Center Representative, Intermediate (Bilingual Spanish) - Wilmington

  • Job
    Full-time
    Entry Level
  • Customer Relations
  • Long Beach

AI generated summary

  • You need 3+ years experience, Spanish fluency, Medi-Cal knowledge, customer service skills, and a positive attitude to be our Community Resource Center Representative in Wilmington.
  • You'll be connecting members to health services, resolving inquiries, coordinating membership changes, conducting outreach, and assisting with hosting events at the Community Resource Center.

Requirements

  • Requires at least 3 years of professional experience
  • Requires broad knowledge of operational systems and practices typically gained through extensive experience and/or education
  • Requires being bilingual in Spanish as demonstrated by successful completion of an oral language proficiency test
  • Requires at least 6 months of experience with Medi-Cal enrollment guidelines, specifically Medi-Cal renewal/redetermination process
  • Requires customer service background
  • Must demonstrate a positive attitude, flexibility, professionalism, and dependability in all workplace activities

Responsibilities

  • Resolve issues and inquiries concerning members eligibility, benefits, provider information, clinical, pharmacy and other health or social service needs
  • Compose routine and non-routine correspondence to answer benefits/provider inquiries in writing
  • Coordinate membership changes such as member’s primary care physician. May participate in quality and efficiency workgroups to continuously improve quality member/customer satisfaction
  • Analyze available programs, determine program eligibility, and connect member to appropriate BSC vendors, Health Advocates, Social Workers, Pharmacy Techs, and Pharmacists
  • Conduct outreach calls and activities to inform members about the Community Resource Centers, how to access health plan benefits, and assist with scheduling appointments
  • Coordinates membership changes such as member’s primary care physician
  • Verify the member is included in or targeted for any outreach or care gap programs and connect members to programs or services when appropriate
  • Assist with organization and hosting of unique quality events and participating in on-site, off-site Community Resource Center activities

FAQs

What are the main responsibilities of a Community Resource Center Representative, Intermediate (Bilingual Spanish) in Wilmington?

The main responsibilities include resolving issues and inquiries concerning member eligibility, benefits, and provider information, coordinating membership changes, analyzing available programs and connecting members to appropriate services, conducting outreach calls to inform members about the CRC, and assisting with organizing and hosting quality events.

What qualifications are required for this position?

This position requires at least 3 years of professional experience, broad knowledge of operational systems and practices, bilingual proficiency in Spanish, 6 months of experience with Medi-Cal enrollment guidelines, and a background in customer service.

What tasks does the Community Resource Center Representative perform on a daily basis?

The representative handles inquiries from members, composes correspondence to answer benefits/provider inquiries, coordinates membership changes, connects members to appropriate services, conducts outreach calls, and assists with organizing quality events and activities at the CRC.

How are members connected to social services and care planning by the CRC representative?

The representative analyzes available programs, determines program eligibility, and connects members to appropriate vendors, Health Advocates, Social Workers, Pharmacy Techs, and Pharmacists as needed for social services and care planning.

What qualities are important for a Community Resource Center Representative to possess?

A positive attitude, flexibility, professionalism, and dependability are important qualities for a CRC representative to possess in order to effectively assist members and engage in CRC-sponsored activities.

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Finance
Industry
5001-10,000
Employees
1939
Founded Year

Mission & Purpose

Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. Blue Shield of California is a tax-paying, nonprofit, independent member of the Blue Shield Association with 4.7 million members, 7,800 employees, and $22.9 billion in annual revenue. Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California. Blue Shield of California complies with applicable state laws and federal civil rights laws, and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability.