Member Services Representative-Call Center-Bilingual Spanish

Johnson Service Group, Inc.; Irvine (CA); Remote; USD 29,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Short-term disability

401(k)

Job summary

Johnson Service Group, Inc. is seeking a Member Services Representative to support health insurance inquiries. This remote role requires living in PST, MT, or Central Time Zone and pays $21.00 per hour.

You will handle benefits, eligibility, claims, and reimbursements while maintaining HIPAA/ERISA compliance. Responsibilities include assisting clients via phone, email, and case management; educating on program eligibility; researching discrepancies; and collaborating with departments to improve

Qualifications

• Fluent in English and Spanish with strong speaking and writing skills.
• 1-3 years of claims, accounting, or customer service experience or related education.
• Solid knowledge of health insurance procedures including eligibility, billing, and compliance.
• Proficiency with Microsoft Office and basic computer systems.
• Excellent time management, multitasking, and problem-solving abilities.

Responsibilities

• Provide outstanding customer service via phone, email, and case management for benefits, claims, and reimbursements.
• Educate clients on eligibility and guidelines, resolving reimbursement and claims issues in real time.
• Research and resolve eligibility discrepancies, process claims, and ensure accuracy across systems.
• Maintain HIPAA/ERISA compliance while handling sensitive client information.
• Collaborate across departments to streamline processes, report metrics, and suggest improvements.

Skills

Bilingual English/Spanish

1-3 years of claims/customer service

Health insurance procedures knowledge

Microsoft Office Suite

Time management and multitasking

Teamwork and professionalism

Education

High school diploma or equivalent

Healthcare background preferred

Tools

Microsoft Office Suite

Job description

Johnson Service Group (JSG) is seeking Member Services Representatives to help support health insurance inquires. Remote- Must Live in PST, MT or Central Time Zone. This exciting role offers the opportunity to deliver exceptional customer service and support to key clients, ensuring their benefit, eligibility, and reimbursement needs are managed efficiently and accurately. Join a collaborative team where your language skills and healthcare knowledge can make a real difference in people's lives, all while working remotely within a supportive company culture. Pay rate: $21.00 per hour. If you're bilingual, detail-oriented, and passionate about providing top-notch service, we want to hear from you.

What You'll Do:

• Provide exceptional customer service via phone, email, and case management to assist clients with benefits, claims, and reimbursements.
• Educate clients on program eligibility and guidelines, resolving issues related to reimbursements and claims in real-time.
• Research and resolve eligibility discrepancies, process claims, and ensure accuracy across internal systems.
• Maintain compliance with HIPAA and ERISA regulations while managing sensitive client information.
• Collaborate across departments to streamline processes, report on performance metrics, and suggest process improvements to enhance efficiency.

Required Skills:

• Fluency in both English and Spanish, with excellent speaking and writing skills.
• 1-3 years of claims, accounting, or customer service experience, or a related educational background.
• Strong knowledge of health insurance procedures, including eligibility, billing, and regulatory compliance.
• Proficiency in Microsoft Office Suite and basic computer systems.
• Exceptional time management, multitasking, and problem-solving abilities.
• Ability to work independently or within a team, maintaining professionalism and accuracy.

Nice to Have Skills:

• Prior experience with case management systems and Electronic Data Interchange (EDI).
• Knowledge of health insurance laws such as HIPAA and ERISA.
• Experience handling health care reimbursement and claims processing.

Preferred Education and Experience:

• High school diploma or equivalent required.
• Healthcare-related background or previous claims/customer service work is highly preferred.

Other Requirements:

• Ability to work remotely in a designated, secure workspace with wired Ethernet internet connection.
• Flexibility to work typically from 8 am - 5 pm PST, with some hours ranging from 7:55 am to 5:15 pm.
• May be required to attend at least one in-person customer engagement annually.
• Certification or additional training in health care billing or customer service is a plus, but not mandatory.

Benefits and Perks:

• 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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