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 Member Care Representative to manage interactions with health plan members and healthcare providers. This role involves assisting clients via telephone, email, and online chat, providing guidance on benefits and plan features, coordinating enrollment requests, and investigating member concerns. The representative will play a crucial role in helping members understand their healthcare options and maintaining positive relationships throughout their healthcare journey.

Key Responsibilities

• Manage incoming and outgoing interactions with health plan members and healthcare providers.
• Assist clients through telephone, email, and online chat channels.
• Provide guidance on member benefits, plan features, coverage questions, account updates, and transaction-related requests.
• Coordinate enrollment requests and plan modifications with appropriately licensed representatives.
• Investigate member concerns related to billing, services, and benefits, escalating complex matters to the appropriate internal team.
• Record detailed and accurate information regarding member interactions within the company’s CRM system.
• Maintain up-to-date knowledge of available health plans, products, services, and applicable procedures.
• Help members better understand their healthcare benefits and available options so they can make informed decisions and get the most value from their coverage.
• Develop positive relationships with members and provide consistent support throughout their healthcare journey.
• Work toward individual and team performance objectives, including service quality, member satisfaction, productivity, call handling efficiency, attendance, and schedule compliance.
• Participate in departmental meetings, training sessions, coaching activities, and ongoing professional development.

Qualifications

• Strong interpersonal, written, and verbal communication abilities.
• Comfortable working with Microsoft Office applications, including Word, Excel, Outlook, and Teams.
• Demonstrated ability to manage multiple tasks at once while communicating with customers, entering information, and working across several computer systems.
• Spanish language proficiency is a plus; eligible bilingual employees may receive additional compensation.
• Prior experience in health insurance, dental insurance, or dental office front desk patient scheduling is preferred.
• 911 Dispatcher or emergency call operator background (proven success with high-stress de-escalation) is preferred.

Experience

• Minimum of two years of experience in customer support, contact center, or a similar client-facing environment.

Skills

• Microsoft Office (Word, Excel, Outlook, Teams) proficiency.
• CRM system experience (for recording member interactions).
• Strong communication (interpersonal, written, verbal).
• Multitasking and organizational skills.
• Customer service and de-escalation skills.
• Spanish Bilingual fluency (preferred).

Education

• Associate’s or bachelor’s degree is preferred but not mandatory.

Additional Requirements

This position operates Monday-Friday, 8:30 AM - 5:30 PM.

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.

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