Call Center Representative (Healthcare-Insurance exp)

Torrance, CA 90505 | Temp-to-Hire

Job ID: [TO] Industry: Healthcare Pay Rate: 17-19

We are recruiting for an experience Call Center Rep with experience within the healthcare/Insurance industry.

Candidate will respond accurately and promptly to telephone inquires regarding claims, benefits and eligibility.

  • Expected to take 6 calls per hour/48 calls per day to meet the set standard of production.
  • With the average speed of answer (ASA) of 30 seconds and an abandonment rate of 3%.
  • Expected to reach the goal of 20 minutes of after call work per day.
  • Call hold times should not exceed 2 minutes without following up with the caller.
  • CRM issues should be closed within 15 business days.
  • Understanding of plan benefits in order to provide current and accurate information to a caller.
  • 100% documentation is expected for each call received.
  • Call quality should be at 90% and above for all call quality audits.
  • Escalated issues should be followed up within 5 business days of receipt.
  • Attendance is an essential part of the job function and excessive unscheduled tardiness or absenteeism's will be addressed individually.
  • Provide customer service to clients, providers and plan participants.
  • Request additional information from external sources when required.
  • Review complex or unusual claim situations
  • Review claims previously processed incorrectly and forward to designated personnel with recommended corrective actions.
  • Handle claim processing/adjustments as needed
  • Issue written correspondence to clients, providers or plan participants.
  • Record call data in call tracking system.
  • Research claims status.
  • Respond to benefit questions.
  • Assist with eligibility issues.


Other duties as assigned.


We will consider for employment all qualified Applicants, including those with Criminal Histories, in a manner consistent with the requirements of applicable state and local laws , including the California Fair Employment and Housing Act (FEHA).

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