Customer Service Representative - Maui, Kauai, Hilo or Oahu

The Company

Aloha Care is a local, non-profit health plan serving Hawai`i’s low-income residents with free Medicaid and dual Medicare health insurance coverage. Our members include children, seniors and adults residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care. Our approach is to meet the whole-person health and social needs of members.

Through our community partnerships we offer innovative services such as connection to social service agencies, Native Hawaiian healing services and in‑home primary care for qualified members. Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all. We are Hawaii’s third‑largest health plan and offer a wide network of quality primary care, specialists, hospitals, pharmacies and among many other providers across the state.

Aloha Care employees have a passion for helping Hawai`i’s most underserved communities. Our caring culture is fundamental to our company‑wide team approach to providing high quality services. We support our employees with a supportive and positive work environment, healthy work‑life balance, continuous communication, and a generous benefits package.

Aloha Care’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization‑wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust‑building. We encourage open‑door, two‑way, and frequent communication.

Aloha Care’s comprehensive benefits package includes low‑cost medical, dental, drug and vision insurance, paid time‑off, 401k employer contribution, referral bonus and pretax transportation and parking program.

The Customer Service Representative is a customer‑focused, detail‑oriented service representative that supports customers through inbound and outbound phone, digital, and occasional face‑to‑face service channels, using the highest degree of expertise, courtesy, and professionalism with the objective of retaining the customer's business and ensuring their on‑going satisfaction.

• Fields a wide range of incoming member and provider routine and complex calls, emails, texts, and chats concerning benefits, services, claims, and other inquiries.
• Ability to handle member inquiries, complaints, concerns, and discrepancies in a professional and caring manner.
• Works in multiple queues/skill sets over various client contact channels.
• Responds to all incoming inquiries relating to member eligibility and assists members in understanding and navigating the enrollment process into the QUEST Integration program and Medicare program.
• Maintains data integrity by entering and updating information in member and provider databases, keeping accurate account of all contact transactions.
• Implements routine tasks including producing copies, mailings, faxes, and recording all correspondence as indicated.
• All other duties assigned.
• Adhere to regulatory compliance and quality guidelines as well as Aloha Care policies and procedures.
• Responsible to maintain Aloha Care’s confidential information in accordance with Aloha Care policies, state and federal laws, rules and regulations regarding confidentiality. Employee access to Aloha Care data is based on the classification assigned to this job title.

• High school diploma or equivalent.
• Minimum of 1 year of customer service, sales and/or customer facing responsibilities.
• Achieves results, builds trust, communicate effectively, customer and quality focused.
• Stro…