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Customer Service Representative

San Francisco Health Plan

San Francisco Health Plan

Customer Service
San Francisco, CA, USA
Posted on Thursday, February 9, 2023

As a Customer Service Representative, you'll provide health plan information and assistance, including plan benefits, updates, programs, policies, complaints and procedures. You will learn a wealth of knowledge and grow your client relation skills by improving every member's call experience and help address any questions and issues. Reporting to the Customer Service Supervisor, you will serve San Francisco Health Plan (SFHP) clients, among them our Health Plan members, prospective members, providers, staff members and the public in general.


  • Respond to customer inquiries.
  • Answer telephone calls promptly and minimize delays that may lead to abandoned calls.
  • Verify member eligibility, coverage or exclusion of services.
  • Assist members in selecting or changing personal doctors or medical groups according to established guidelines.
  • Inform and educate customers on Plan policies, procedures and services.
  • Promote the rights and responsibilities of Plan members.
  • Provide information, referrals and coordinate member services with community resources for covered and non-covered services.
  • Participate in activities that reach out to prospective members and to the communities that the Plan serves.
  • Make outbound calls to members to inform them about Medi-Cal redetermination and the necessary steps to maintain their healthcare coverage.
  • Provide clear and concise information on the redetermination process, including how to contact Medi-Cal directly.
  • Maintain accurate records of all calls and outcomes in SFHP’s platform.
  • Collaborate with the team to share knowledge and improve processes.
  • Be prepared to take on additional tasks or projects as needed to support the team and overall business objectives.


  • 1+ years of experience in customer service, call center, or similar
  • Bilingual fluency in Cantonese/Mandarin or Spanish
  • Experience in communicating confidential information
  • MS Office and customer management applications experience
  • Ability to produce accurate, precise and quality work in a diverse environment
  • Familiarity with health care and managed care terminology desired
  • Prior experience in health care and knowledge of managed care or Medi-Cal preferred
  • College degree or equivalent work experience


  • Medical Plans: You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California. Employee-only coverage in the HMO plans is currently available at no cost and dependent coverage is heavily subsidized by SFHP.
  • Dental: You’ll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
  • Vision: Employee vision care coverage is available at no cost.
  • Time Off: 23 days of Paid Time Off and 12 observed company holidays.
  • Professional development: Opportunities for tuition reimbursement, professional license/membership.

Established in 1994, San Francisco Health Plan (SFHP) is an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 170,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.

San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

San Francisco Health Plan is an E-Verify participating employer.

Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.