Member Enrollment- Program Assistant

Johnson Service Group; Orange (CA); On-site; USD 33,000 - 46,000; Full time

Benefits offered by this job

Weekly pay

Job summary

Johnson Service Group (JSG) is seeking a Member Enrollment – Program Assistant to support the Premium Billing & Member Enrollment team on-site in Orange County, CA. Schedule is Monday–Friday, 8:00 a.m.–5:00 p.m.; pay rate is $24.00/hr - $33.50/hr DOE.

You will help keep enrollment processes accurate and compliant, including eligibility analyses, provider assignments, and member requests, while preparing reports using Excel and Access.

Qualifications

• High school diploma or equivalent.
• 1+ year of eligibility and/or reconciliation experience.

Responsibilities

• Coordinate enrollment processes (eligibility analysis, provider assignments, age restrictions, complex condition monitoring, floor audits).
• Assist with member requests (health network changes, PCP change requests, data correction forms).
• Interpret policies/regulations and respond to questions.
• Prepare letters/surveys and coordinate data files (mail merges).
• Document workflows, desktop procedures, and policies to support compliance.
• Create reports and tools; perform reconciliations using Excel and Access.
• Support quality audits related to PHI/AOR and acceptance letter updates.
• Conduct outreach to members and health carriers to verify potential other health coverage.
• Sort and track returned mail and maintain logs.

Skills

Customer service

Bilingual English + threshold language

Education

High school diploma or equivalent

Tools

Excel

Access

Job description

Johnson Service Group (JSG) is hiring a Member Enrollment – Program Assistant for an on-site assignment supporting the Premium Billing & Member Enrollment team for a Health Plan partner in Orange County, CA. Work schedule: Monday–Friday, 8:00 a.m.–5:00 p.m. Pay rate: $24.00/hr - $33.50 per hour DOE.

You’ll support day-to-day program operations and help keep enrollment processes accurate, compliant, and member-focused, including:

• Coordinating specialized enrollment processes (e.g., eligibility analysis, provider assignments, age restrictions, complex condition monitoring, and floor audits for the Medi-Cal program)
• Assisting with member requests such as health network changes, PCP change requests, and data correction forms
• Interpreting policies/regulations and responding to questions
• Preparing letters/surveys and coordinating data files (including mail merges)
• Documenting workflows, desktop procedures, and policies to support compliance
• Creating reports and tools; performing reconciliations using Excel and Access (sorts/merges, filters, compiling reports, database procedures)
• Supporting quality audits related to PHI/AOR and acceptance letter updates
• Conducting outreach to members, and to health insurance carriers to verify potential other health coverage (OHC)
• Sorting and tracking returned mail and maintaining accurate logs

Must-Have Qualifications

• High school diploma or equivalent
• 1+ year of eligibility and/or reconciliation experience (or equivalent combination of education/experience)

Nice-to-Have

• Medi-Cal and/or health insurance experience
• Experience in HMO/managed care settings
• Customer service experience
• Experience with DHCS/DMHC interactions and Medi-Cal practices
• Bilingual in English and one threshold language (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese)

JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more.

Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.

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