ZipRecruiter

Log In

1

Medicare Inbound Jobs in California (NOW HIRING)

previous page

Showing results 41-60

All JobsMedicare Inbound JobsMedicare Inbound Jobs in California

Medicare Inbound information

What is a Medicare Inbound representative?

Medicare Inbound representatives are customer service professionals who handle incoming calls from individuals seeking information about Medicare plans, enrollment, and benefits. They assist callers—often seniors or those approaching eligibility—with understanding plan options, coverage details, and the enrollment process. Their role is crucial in providing accurate, clear information to help people make informed healthcare decisions. These representatives often work for insurance companies or third-party agencies that support Medicare beneficiaries.

What skills and qualifications are needed to thrive as a Medicare Inbound representative?

To excel as a Medicare Inbound Representative, you typically need strong knowledge of Medicare plans, excellent customer service skills, and a high school diploma or equivalent. Familiarity with CRM systems, call center software, and sometimes a health insurance license are important technical qualifications. Outstanding communication, patience, and problem-solving abilities help representatives build trust and effectively address client needs. These competencies ensure accurate information delivery, regulatory compliance, and a positive customer experience for Medicare beneficiaries.

What are common challenges faced by Medicare Inbound representatives, and how can they be managed?

Medicare Inbound representatives often encounter challenges such as handling high call volumes, addressing complex customer inquiries about benefits and coverage, and staying current with frequently changing Medicare regulations. To manage these challenges, it's important to develop strong organizational skills, utilize internal resources and knowledge bases, and actively participate in ongoing training. Effective communication and patience are also key, as representatives regularly interact with seniors who may need extra assistance understanding their options.

What is the difference between Medicare Inbound vs Medicare Customer Service Representative?

AspectMedicare InboundMedicare Customer Service Representative
CertificationsKnowledge of Medicare policies, possibly required certificationsSame certifications, focus on Medicare knowledge
Work EnvironmentCall centers, remote or office-basedCall centers, remote or office-based
Employer & IndustryHealth insurance companies, Medicare providersHealth insurance companies, Medicare providers
Job FocusHandling inbound calls about Medicare plans and coverageAssisting customers with Medicare inquiries and issues

Both roles involve assisting Medicare beneficiaries via inbound calls, requiring similar certifications and work environments. The main difference lies in job titles used by employers, but their responsibilities and industry context are closely aligned.

What are popular job titles related to Medicare Inbound jobs in California?

For Medicare Inbound jobs in California, the most frequently searched job titles are:

What job categories do people searching Medicare Inbound jobs in California look for?

The top searched job categories for Medicare Inbound jobs in California are:

What cities in California are hiring for Medicare Inbound jobs?

Cities in California with the most Medicare Inbound job openings:

Medicare Inbound jobs near you
Infographic showing various Medicare Inbound job openings in California as of August 2026, with employment types broken down into 85% Full Time, 10% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution.

Customer Service Representative (Cantonese or Mandarin Speaking)

Astrana Health, Inc.

El Monte, CA • On-site

$19 - $22/hr

Full-time

Medical

Posted 18 days ago

Key responsibilities

  • Answer all daily telephone calls from members, providers, health plans, insurance brokers, collection agents, and hospitals.

  • Collect, elicit, and document information from members and providers regarding problems, concerns, and status updates.

  • Verify authorization, claims, eligibility, and status, and assist with member outreach communications and appointment arrangements.

Job description

Description
Job Title: Customer Services Representative 
Department: Operations - Member Services
  
About the Role: Astrana is looking for a Customer Service Representative to join our fast and growing Dynamic team. This position requires speaking fluent in Cantonese or Mandarin to assist with our member population.

What You'll Do
  • Answer all daily telephone calls from members, providers, health plans, insurance brokers, collection agents and hospitals 
  • Collect Elicit information from members/providers including the problem or concerns and provide general status information 
  • Verify authorization, claims, eligibility, and status only 
  • All calls carefully documented into Company’s customer service module & NMM Queue system 
  • Member/Provider Service/Representative assists Supervisor and Manager with other duties as assigned 
  • Member outreach communications via mail or telephone 
  • Assist Member appointment with providers 
  • Resolve walk-in member concerns 
  • Able to provide quality service to the customers 
  • Able to communicate effectively with customers in a professional and respectful manner 
  • Maintain strictest confidentiality at all times 
  • Specialist termination notifications sent to members 
  • Urgent Medicare Authorization Approval – Notification to Medicare members 
  • Transportation arrangement for Medicare & Medi-Cal members 
  • Outreach Project Assignments  
INBOUND CALLS: 
  • Member/Provider/Health Plan/Vendor/Hospital/Broker: 
  • All calls carefully documented into Company’s customer service module 
  • Annual Wellness Visit (AWV) – Gift card pick up and schedules 
  • Appointment of Representative (AOR) for Medicare Members 
  • Attorney / Third Party Vendor calls 
  • Authorization status/Modification/Redirection/CPT Code changes/Quantity adds/Explain Denied Auth/Peer to Peer calls/Extend expired auth/Pre-certified auth status/Retro/2ndor 3rd opinion/ 
  • Conduct 3 way conference call to Health Plan with member 
  • Conference call with Providers – Appointments, DME, 
  • COVID – 19 related questions (Tests & Vaccines) 
  • Direct Member Reimbursement (DMR) 
  • Eligibility – Demographic changes: Address/Phone/Fax Changes/Name change 
  • Escalated calls from providers/members 
  • Health Diary Passport 
  • Health Source MSO – Assist & arrange inquiries on Eligibility/Change PCP/Benefit with AHMC 
  • HIPPA Consent – Obtain Member Consent verification 
  • Inquiries on provider network/provider rosters 
  • Lab locations 
  • Member & Provider Complaints/Grievances 
  • Member bills  
  • Miscellaneous calls 
  • Pharmacy – Drug/medication pick up and coverage 
  • Provide authorization status for Hospital /CM Dept 
  • Self-Referral Request for Medicare 
  • Return Mail 
  • Track Mail Packages/ Certified mail status 
  • Translations – Spanish / Chinese 
  • Urgent Care / locations/ operations hours 
  
OUTBOUND CALLS: 
Member/Provider/Health Plan/Vendor/Hospital/Broker: 
  • Assist Case Management on CCS – age in 21 years for change of PCP from Pediatrics to FP/IM 
  • Assist Marketing on email inquiries 
  • Assist PR/ Elig – Members assigned to wrong PCP/with no PCP status 
  • Assisted UM / Medical Directors on urgent member appointment from escalated cases 
  • Authorization status response call back 
  • Benefits – return call once information is obtained / verified  
  • Complaints/Grievances – return calls once resolution is obtained 
  • DME – Translation support in Spanish and Chinese to confirm item / appointment set up for DME department 
  • Eligibility – return call to providers/labs when member is added to system while waiting at the office.  
  • Member bills – return calls once resolution is obtained 
  • Member Survey – Annually: every 4thquarter 
  • Outreach project from internals – QCIT 
  • Resolve walk in members concerns 
  • Specialist Termination notification sent to members 
  • Transportation arrangement for Medicare / Medi-Cal members 
  • Voice mail – return calls back to callers 
 
CONCIERGE SERVICES – ESSENTIALS DUTIES AND REQUIREMENTS: 
  • Assist to contact new members/IPA member transfer on new PCP assignment as needed 
  • Work group discussions on work status/progress on new member/IPA transfer 
  • Update call log and provide daily/weekly status as needed 
  • Facilitate members with complex pre-existing conditions, medications, PCP/SPC network reviews 
  • Conference call with PCP selection / change 
  • Help member to identify member bill status, connect provider with on billing and claim submission 
  • Responsible for experience of the membership associated with new member/IPA transfer 
  • Responsible for to interact with Health Plan’s Customer Service Team to serve new member/IPA transfer 
  • Problem Solving complex cases/ brain storm with MS management team for resolution 
  • Other duties as assigned

Qualifications
  • High School Diploma or GED 
  • Experience using Microsoft applications such as Word, Excel and Outlook
  • Experience working in customer service 
  • One year related experience and/or training; or equivalent combination of education and experience
  • You are fluent in Cantonese or Mandarin
You're a great for this role if:  
  • You have previous work experience working in a healthcare setting 

Environmental Job Requirements and Working Conditions
  • This is a remote role. The home office is aligned with your department at 9700 Flair Drive, El Monte, CA 91731
  • This position is required to work between Monday - Friday at 8:30am to 5:00pm PST.
  • The target pay range for this role is $19.00 - $22.00 per hour. This salary range represents national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.