Customer Service Representative – Health Plan Services
Facility: Scripps Health Corp
Location: San Diego, CA (Remote)
Career Area: Administrative Support
Employment Type: Full Time
Shift: Day
Job ID: 252002263
Let’s Get Started
Scripps Health Administrative Services supports our five hospital campuses, 31 outpatient centers, clinics, emergency rooms, urgent care sites, along with our 17,000 employees, more than 3,000 affiliated physicians and 2,000 volunteers.
Healthcare is constantly changing and so is our workplace. Scripps Health continues to build a flexible work culture that supports a work-life balance consisting of flexible work schedules and full-time remote or hybrid remote opportunities in San Diego County. Now you can surround yourself, virtually, with people who are dedicated to making a difference in how we care for our patients, bringing your purpose to life through the work that you do.
Job Description
This is a benefitted Full Time, Day Shift position with a Monday-Friday schedule and 8AM-4:40PM or 8:30AM – 5PM shift (rotated), located at the 4S Ranch Business Services office in Rancho Bernardo. Staff meetings are held once a month until 7pm. This position is partial remote after training with one a month in the office (the last Thursday).
Why join Scripps Health?
At Scripps Health, your ambition is empowered and your abilities are appreciated:
- Nearly a quarter of our employees have been with Scripps Health for over 10 years.
- Scripps is a Great Place to Work Certified company for 2025.
- Scripps Health has been consistently ranked as a top employer for women, millennials, diversity, and as an overall workplace by various national publications.
- Becker’s Healthcare ranked Scripps Health on its 2024 list of 150 top places to work in health care.
- We have transitional and professional development programs to create a learning environment that enables you to thrive in your specific field as well as in your overall career.
- Our specialties have been nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics, geriatrics, obstetrics and gynecology, and gastroenterology.
Join a wonderful team as a Member Service Representative in our Scripps Health Plan Services department at our 4S Ranch Business Services office. In this position, you will play an important role in supporting our patients’ incoming calls in a call center environment.
Under general direction, primary responsibilities will include the following:
- Providing customer service to plan members and providers by answering complex benefit questions, resolving issues and educating customers.
- Receiving inbound telephone, internet and written inquiries from members and providers regarding covered benefits, claims, referrals and eligibility.
- Making outbound telephone and email contacts to members and providers to provide education and facilitate issue resolution.
- Managing claim checks, checking referral status’, and managing member calls.
- Managing member appeals and grievances.
- Other special projects as assigned.
Required Education/Experience/Specialized Skills:
- 3 or more years of customer service experience.
- 1 or more year of experience in a call center environment.
- Strong written, verbal and listening communication skills.
- Strong problem-solving skills.
Preferred Education/Experience/Specialized Skills/Certification:
- Managed care experience.
- Knowledge of EPIC Tapestry.
- Health Plan experience.
- Health care administration.
In compliance with the California Pay Transparency Act, Scripps Health posts the pay range for all jobs. Please note that actual pay will be determined based on relevant experience and internal equity within the pay range. Please also note this range is applicable for employees who reside in California only. A geographical pay differential may be applied for remote employees who reside out of state. Scripps Health strives to ensure that our employees receive equal pay for equal work in line with our commitment to being an equal opportunity employer.
Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.
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About Us
At Scripps, we seek dedicated, compassionate people to join our team and make a significant impact on the health of our community and the future of health care. Throughout our five hospital campuses, 30 outpatient centers and clinics, and hundreds of affiliated physician offices throughout the region, each member of our team plays a key role in our life-changing and life-saving mission. Our people and their commitment to the highest standards of care are what define us.
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