Job Description
At arenaflex, we're on a mission to deliver exceptional healthcare services to our community, and we're seeking a highly motivated and bilingual Customer Service Representative Sr (OneCare) to join our team. As a senior point of contact for OneCare members and providers, you'll play a vital role in addressing their questions and concerns related to the OneCare plan services. If you're passionate about delivering top-notch customer service, have a strong work ethic, and are fluent in English and one of our defined threshold languages, we encourage you to apply. **About arenaflex** arenaflex is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity, and respect. We're a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We're committed to building a culture that promotes diversity and inclusion, where employees have a sense of belonging and are valued for their ideas, contributions, and unique individual perspectives. **Job Summary** As a Customer Service Representative Sr (OneCare), you'll serve as a senior resource for OneCare members and providers, addressing their inquiries, questions, and concerns related to the OneCare plan services. You'll provide information regarding eligibility, enrollment, benefits, and services, and collaborate with other teams to support short- and long-term goals and priorities. Your exceptional communication skills, attention to detail, and ability to work in a fast-paced environment will make you an invaluable asset to our team. **Key Responsibilities** * Participate in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity, and accountability. * Assist the team in carrying out department responsibilities and collaborate with others to support short- and long-term goals and priorities. * Address member and provider inquiries, questions, and concerns in all areas, including eligibility, enrollment, claims or authorization status, benefit interpretation, and referrals/authorizations for medical care. * Serve as a senior resource for other team members, solving complex challenges, answering uncommon questions, and sharing complex processes and procedures. * Support the coordination of member's healthcare and social service needs within and outside the medical group and arenaflex. * Enter accurate and complete documentation into internal application systems regarding all concerns and/or inquiries from the member and provider interaction. * Initiate referrals to both internal and external care management departments and other department/government or community agencies. * Maintain departmental productivity and quality standards. * Follow through and complete all member and provider inquiries or requests during the original member and provider interaction, providing additional follow-up assistance as needed. **Minimum Qualifications** * High school diploma or equivalent PLUS 2 years of experience in customer/member service, including 1 year of call center capacity required. * Typing speed of 35 words per minute (WPM) required. * Bilingual in English and one of arenaflex's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese) required. **Preferred Qualifications** * 1 year of Health Maintenance Organization (HMO), Medi-Cal/Medicaid, and health services experience. **Knowledge & Abilities** * Develop rapport and establish and maintain effective working relationships with arenaflex's leadership and staff and external contacts at all levels and with diverse backgrounds. * Work independently and exercise sound judgment. * Communicate clearly and concisely, both orally and in writing. * Work a flexible schedule, available to participate in evening and weekend events. * Organize, be analytical, problem-solve, and possess project management skills. * Work in a fast-paced environment and in an efficient manner. * Manage multiple projects and identify opportunities for internal and external collaboration. * Motivate and lead multi-program teams and external committees/coalitions. * Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. **Work Environment** * Work is typically indoors and sedentary, subject to schedule changes and/or variable work hours, with travel as needed. * There are no harmful environmental conditions present for this job. * The noise level in this work environment is usually moderate. **Benefits & Wellness** * Comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. * Flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. * Arenaflex contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. * Access to 457(b) retirement plans with pre/post-tax contribution options. **How to Apply** If you're a motivated and bilingual individual with a passion for delivering exceptional customer service, we encourage you to apply. Please visit our website at [ to submit your application. We look forward to hearing from you! **Equal Opportunity Employer** arenaflex is an equal opportunity employer and makes all employment decisions on the basis of merit. We prohibit unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. Apply for this job