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 dedicated Customer Service Representative to manage a high volume of inquiries from members and healthcare providers. This role primarily focuses on assisting with authorizations, claims, and provider billing, ensuring efficient and accurate processing while maintaining high service levels.

Key Responsibilities

• Handle a high call volume, averaging 60 calls per day.
• Maintain a service level of 80/30, answering 80 percent of calls in 30 seconds or less.
• Assist members and healthcare providers with inquiries related to authorizations, claims, and provider billing.
• Process claims and ensure accuracy in claim handling.
• Collaborate with colleagues in the provider support center to address customer concerns and resolve issues promptly.
• Utilize IDX for claims processing.

Qualifications

• Experience with claims/claims processing.
• Strong understanding of Health Maintenance Organizations (HMOs).
• Familiarity with authorization and referral processes.
• Experience in managing a high call volume efficiently.
• Excellent communication and problem-solving skills.

Experience

• 1+ years of customer service or member service experience.

Skills

• IDX for claims processing (technical skill).
• Communication.
• Problem-solving.

Additional Requirements

• Ability to work independently in a remote setting.
• Schedule is Monday-Friday, 7:30 AM - 4:00 PM PST.

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.

Medix is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

^*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.

Any required state or Joint Commission training is compensated at the state or local minimum wage rate.

^*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