Customer Service Rep
Company: Personnel Solutions Unlimited
Location: Visalia
Posted on: April 2, 2026
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Job Description:
Act as the primary point of contact and liaison for Foundation,
Key Medical Group and delegated health plan members and providers
contacting the plan regarding general inquiries, concerns or
requests for information ? Develop a general understanding of all
member facing materials, communications and interactions and be
prepared to respond appropriately to follow up calls ? Answer
inbound calls and/or place outbound calls in a high call volume
environment and work directly with members and providers to
accurately and completely answer inquiries involving program
services and benefits ? Follow established policies, procedures,
guidelines and resources to respond to member and provider
inquiries and resolve concerns in an accurate, timely,
professional, and culturally competent manner ? Intake, handle and
coordinate member grievances, appeals and claim issues, escalating
to the customer service lead or department manager, when necessary
? Educate members and providers on eligibility, medical and
pharmacy benefits and how to access services in a manner that
achieves excellent service standards and maintains high customer
satisfaction ? Use listening skills and judgment to appropriately
categorize and accurately document all contacts and follow-up
actions regarding member and provider communications and activities
in accordance with established guidelines, policies and procedures
? Appropriately handle member and provider requests through
alternative channels such as e-mail, voicemail, fax, walk-in, etc.
in accordance with established procedures ? Triage member and
provider requests or inquiries for other departments ? Attend and
actively participate in daily, weekly, and monthly departmental
meetings, in-services, training and coaching sessions ? Identify
member/provider issues and trends and report relevant information
to the customer service lead or manager ? Perform other related
duties as required or assigned. Call Center experience a
plus/Bilingual Spanish a plus.
Keywords: Personnel Solutions Unlimited, Clovis , Customer Service Rep, Customer Service & Call Center , Visalia, California
