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Every position with MedPOINT management contributes to a higher purpose – to help sustain accessible, affordable, quality care in the beautiful and diverse communities we serve.

Claims Inquiry Unit – Call Center Representative


To serve as a liaison between IPA and its members. Ensures that all members receive a level of service that exceeds their expectations. Respond to and resolve questions and problems from current members, or their representative, providers, and other appropriate parties.

Duties and Responsibilities

  • Benefit clarification, eligibility, verification, and claim status.
  • Medical group/PCP provider assignments
  • Explanation of how the plan works and how to utilize the services
  • Assist with information regarding referral or authorization
  • Request change of provider/member information
  • Any complaints/grievances
  • Update new member eligibility on appropriate systems
  • Perform overrides for covered/authorized prescriptions as needed
  • Participate as a team player by demonstrating support to peers, management, and the department’s goals
  • Attend meetings and training sessions as scheduled
  • Assist with training new employees as needed
  • Show flexibility in meeting performance objectives consistent with IPA and department objectives
  • Document all member inquiries and complaints in appropriate systems and either handle, redirect, or defer to the appropriate department for resolution.

Minimum Job Requirements

  • High school diploma. Two years of Customer Service/Telemarketing sales or related experience. Knowledge of Medi-Cal, Managed Care plans

Knowledge, Skills and Abilities Required

  • Must be computer literate, typing 30 wpm
  • Excellent telephone techniques
  • Excellent interpersonal and communication skills; strong writing skills
  • Medical Front Office experience preferred
  • Bilingual in Spanish preferred

Working Conditions and Physical Effort

  • Regular and reliable attendance is an essential function of the position.
  • Work is normally performed in a typical interior/office work environment.
  • No or very limited physical effort required. No or very limited exposure to physical risk.

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Job title: Claims Inquiry Unit – Call Center Representative

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