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 Team Representative to join the Member Experience team. The primary responsibility of this role is to alleviate administrative burdens from members by addressing basic customer service queries while also helping with questions about benefits, eligibility, and claims.

Key Responsibilities

• Provide customer service by answering member or provider queries about deductibles, coinsurance, and out-of-pocket amounts.
• Handle provider calls that often involve discussions about claims and benefits.
• Explain benefits to members clearly and effectively.

Qualifications

• Approx. 3 years of insurance customer service experience
• Strong understanding of claims and ability to follow up on claims
• Experience with Explanation of Benefits (EOB) and eligibility processes
• Strong phone and written communication skills
• Prefer experience with commercial health insurance over Medicare/Medicaid

Skills

• Technical Skills: High-level understanding of insurance claims, EOB, eligibility, secure internet usage, and ability to set up a secondary monitor and other equipment.
• Soft Skills: Strong communication skills, ability to handle demanding providers, and excellent problem-solving skills.

Additional Requirements

• Must provide personal equipment including second monitor, mouse, headset, and desk.
• Secure, private workspace with secure Wi-Fi and a backup internet solution required.
• Ability to use a phone as a hotspot if needed.

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.

Required Employment / Compliance Language

Medix provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, or genetics.

^*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