You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Member Service Representative who will provide confidential and highly responsive engagement and support services to members. The role involves serving as the primary point of contact for benefits, eligibility, claims, and healthcare education while ensuring issue resolution. The representative will collaborate with various teams to communicate and encourage the utilization of benefits according to plan design and optimize the member’s experience.

Responsibilities / Job Duties

• Serve as the primary point of contact for members regarding benefits, eligibility, claims, and healthcare education.
• Respond to inbound calls, return voicemails, and meet with members in person to answer inquiries about plan benefits.
• Proactively establish and maintain collaborative relationships with members.
• Support new membership enrollment activities and partner with relevant teams on related activities, including participation in healthcare programs.
• Research benefits, eligibility, and claim issues and initiate corrective actions.
• Maintain databases, information systems, programs, processes, policies, procedures, and forms to ensure compliance and clarity.
• Manage membership communications and ensure timely, compliant submission and distribution of notices and filings.
• Ensure compliance with applicable health plan regulations and standards.
• Partner with Employer Services to provide timely benefit coverage for eligible membership.
• Participate in benefit presentations as needed.

Minimum Education and Experience Qualification Requirements

Education

• Associate’s degree in healthcare, healthcare administration, business, finance, operations, or a related field (preferred).

Qualifications

• Bilingual in English and Spanish.
• 1+ years of experience in a healthcare, insurance, union, or health plan call center setting, explaining eligibility and/or benefits.

Skills

• Bilingual English/Spanish proficiency required.

Schedule / Shift

Monday - Friday 8am-5pm. This is a hybrid role requiring onsite work 2-3 days per week, with a set schedule for remote and in-office work determined upon starting based on business needs.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients