We are looking for experienced Healthcare Customer Service Representatives to provide comprehensive support to members regarding Explanations of Benefits (EOBs), reimbursements, and referrals. This role requires a strong understanding of healthcare processes and the ability to navigate complex inquiries in a fast-paced call center environment.

Key Responsibilities:
Explanation of Benefits (EOB) and Reimbursement:
Provide detailed explanations to members regarding their EOBs, clarifying charges, payments, and coverage details.
Process and resolve member inquiries related to reimbursement claims, ensuring accurate and timely resolution.
Investigate and address discrepancies in billing and payments.
Referrals:
Process and manage referral requests, ensuring timely authorization and scheduling.
Provide members with accurate information regarding referral procedures and provider networks.
Follow up on referral status and communicate updates to members.
Call Center Operations:
Answer inbound calls in a high-volume call center environment, providing professional and courteous service.
Accurately document all member interactions and inquiries in the system.
Maintain a high level of product knowledge and stay updated on changes in policies and procedures.
Resolve member issues and concerns efficiently and effectively.
Compliance:
Adhere to all HIPAA regulations and maintain confidentiality of member information.

Qualifications:
Minimum of 1 year of experience in a healthcare customer service role, with specific experience handling Explanations of Benefits (EOBs), reimbursements, and referrals.
Proven experience in a high-volume call center environment.
Strong understanding of healthcare terminology and processes.
Excellent communication and interpersonal skills.
Ability to handle sensitive information with discretion and professionalism.
Must be able to pass a background check and drug test.
Must complete skills assessments, including typing and data entry assessments.
Must be able to work onsite in Bakersfield, CA.

Apply for this great position as a healthcare customer service today! resumes to be sent attention Yarely Villalpando yvillalpando(@)appleone.com

EEO/AA Employer/Vet/Disabled.

The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.