Customer Service Representative (Health Resource Representative I)

US-CA-Los Angeles
2 weeks ago(1/4/2018 3:44 PM)
# of Openings
Customer Service/Support





Looking for a way to influence the health and healthcare of many?


If so, we’d love to hear from you! Our mission-driven organization is focused on theTriple Aim - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.


UNITE HERE HEALTH serves 100,000+ workers and 220,000 covered lives in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!



Key Attributes:


  • Integrity – Must be trustworthy and principled when faced with complex situations
  • Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required
  • Communication – Ability to generate concise, compelling, objective and data-driven reports
  • Teamwork – Working well with others is required in the Fund’s collaborative environment
  • Diversity – Must be capable of working in a culturally diverse environment
  • Continuous Learning – Must be open to learning and skill development.  As the Fund’s needs evolve, must be proactive about developing new areas of expertise
  • Lives our values – Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)



The purpose of this position is to be the face of the fund, especially to participants and to provide benefit, claim and health care education and information to this multi-cultural community. The Health Resource Team Representative shares the UNITE HERE HEALTH message by encouraging the utilization of benefits according to plan provisions and best healthcare value.


  • Acts as the positive “face” of the Fund as the main point of contact for the Fund’s participants, unions, employers, providers, and vendors
  • Provides benefit plan and eligibility information to participants, providers, unions, employers and others
  • Provides proactive education to participants by phone and in person at the office
  • Receives and records telephone inquiries regarding plan benefits
  • Assists in participant outreach and encourages them to take steps to get involved in programs to improve their health
  • Utilizes effective listening skills to recognize and communicate issues to management including trends and anomalies
  • Performs research on benefit issues and initiates corrective action if needed
  • Maintains a positive relationship with providers and vendors
  • Maintains an up-to-date knowledge of all factors relating to plan benefits including benefit materials, processes, policies, etc. that will affect day-to-day communication and performing of daily tasks
  • Seeks assistance on issues unable to resolve independently in a timely manner
  • Effectively uses Health Resource Team systems
  • Understands basic claims and self-pay functions
  • Understands enrollment requirements
  • Maintains awareness of work volumes and service levels
  • Assists daily office operations as needed
  • As assigned, works outside of traditional office hours and locations to reach participants
  • Other duties as assigned within the scope of responsibilities and requirements of the job



  • Minimum of 1 year experience in a healthcare, insurance, Union or community engagement environment is preferred
  • College degree preferred or equivalent work experience
  • Experience with performing customer service duties in person and/or over the phone
  • Call center experience is preferred
  • Experience with multi-cultural communities
  • Minimum level computer skills in a Microsoft Office (Word, Excel, Outlook) environment: Intermediate
  • Bi- or Multi- lingual skills (written and verbal) required
  • Excellent service and communication skills required, including the ability to engage participants in conversations, and communicate empathy


Ability to:

  • Manage competing deadlines and multiple projects in a fast-paced environment
  • Work positively, and productively as part of a team
  • Work with union and contributing employer representatives to foster a positive relationship and solve problems with the fund
  • Maintain confidentiality
  • Perform the essential functions of this job with or without reasonable accommodation


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