Bayside Solutions · 20 hours ago
Customer Service Navigator
San Mateo County, CA
Contract
Onsite
Entry Level
$48K/yr - $52K/yr
1+ years expBayside Solutions is a staffing agency seeking a Customer Service Navigator. The role involves responding to member and provider inquiries, providing support on health plan benefits and services, and acting as the primary point of contact for members.
Telecom & CommunicationsHuman ResourcesAppsInformation TechnologyStaffing AgencyTelecommunicationsVirtual Reality
No H1B
Responsibilities
Handle high-volume inbound/outbound calls and other communications with professionalism
Follow established scripts, guidelines, and policies while protecting member confidentiality (HIPAA compliance)
Provide culturally competent, accurate, and clear information to members and providers
Resolve inquiries, concerns, grievances, appeals, and billing issues
Escalate complex issues to the appropriate departments when necessary
Educate members about eligibility, benefits, provider networks, and PCP selection/changes
Accurately document interactions and follow-up actions
Refer members to community partner agencies (behavioral health, aging services, legal aid, etc.) as needed
Collaborate with other company departments for complex inquiries or care coordination
Identify opportunities to improve processes and enhance the member experience
Attend training, departmental meetings, and coaching sessions
Cross-train on other tasks to maintain operational continuity
Conduct outreach calls (welcome calls, targeted outreach)
Represent our company at health fairs, community events, and meetings
Perform other duties as assigned
Qualification
Required
High school diploma or GED
1+ years of customer service or call center experience (healthcare/public sector preferred)
Microsoft Office (Word, Excel, PowerPoint, Outlook)
Health insurance and medical terminology
Call center quality metrics and best practices
Strong verbal and written communication with diverse audiences
Teamwork, cooperation, and relationship-building skills
Adaptability to changing priorities and deadlines
Analytical and problem-solving skills to influence positive outcomes
Maintain confidentiality of health information
Proficiency in using computers and Microsoft Office applications
Preferred
Bilingual (Spanish, Mandarin, Cantonese, Tagalog) preferred
Experience with managed care plans, Medi-Cal, Medicare, or underserved populations is a plus
Company
Bayside Solutions
Bayside Solutions is a staffing and recruiting company offering IT, telecom, and scientific staffing services.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
B
Bob Klotz
Founder
Company data provided by crunchbase