Member Services Representatives - Medicare (Short-Term)

Inland Empire Health Plans; Rancho Cucamonga (CA); On-site; USD 40,000 - 55,000; Part time

Benefits offered by this job

Competitive salary

State of the art fitness center

Medical Insurance with Dental and Vis

Job summary

Inland Empire Health Plans is looking for a Medicare Member Services Representative dedicated to assisting members with Medi-Cal, Medi-Medi, and Medicare benefits. This role emphasizes compassionate advocacy and helping members navigate the healthcare system effectively.

The right candidate will possess excellent communication skills and a strong background in customer service in a healthcare setting. This is a short-term, non-benefit eligible position potentially leading to permanent employment

Qualifications

• Minimum of two years HMO or Managed Care customer service experience.
• High School Diploma or GED is required.
• Bilingual proficiency is highly preferred.

Responsibilities

• Assist members in navigating the healthcare system.
• Provide guidance on benefits and medical claims.
• Collaborate with inter-departments to meet member needs.

Skills

Customer service experience

Microsoft Office Suite

Medical terminology knowledge

Multi-tasking skills

Excellent communication

Typing speed

Attention to detail

Education

High School Diploma or GED

Tools

Cisco Finesse

Verint

HSP

Job description

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to anauthentic experience!

Medicare Member Services Representative is responsible for being a devoted and compassionate advocate for Medi-Cal, Medi-Medi and Medicare Members when assisting with maximizing their benefits, navigating the healthcare system and reaching their optimal health. Using multiple complex systems, responsible for providing guidance and answering questions from Members about their benefits and medical claims, as well as educating Members about wellness programs. Assisting Members in assessing tools available to help guide decision-making about complex matters related to their wellbeing. Facilitate the Members selection and access to in‑network healthcare providers. Collaborate with inter‑departments to ensure Member needs are met.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

This is a short-term role with a duration of up to 6 months. Please note that this position is not eligible for benefits.

While there is a possibility that this role could lead to a permanent position, permanent employment is not guaranteed and will depend on business needs, performance, and other factors.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Education & Requirements

• Internal Candidates:
  • A minimum of twelve (12) months experience as an IEHP Member Services Representative required
  • May substitute with two (2) years of experience in a medical setting
• External Candidates:
  • Two (2) years of HMO or Manage Care customer service experience analyzing and solving customer problems
• High School Diploma or GED required
• This is a non-bilingual: bilingual highly preferred position. Identified bilingual team members in this role must take a language proficiency assessment and must receive a passing score.

Key Qualifications

• Knowledge of Medicare managed care is preferred
• Knowledge of Medical terminology, and Medi-Cal managed care is required
• Understanding of and sensitivity to multi-cultural community.
• Proficiency in Microsoft Office Suite; high level capacity to multitask
• Excellent multi-tasking skills
• Typing 35 words per minute, proficient in Windows applications, and experience in data entry
• Knowledgeable of with the following programs: Cisco Finesse, Verint, HSP, Microsoft
• Excellent written and verbal communication and interpersonal skills
• Strong organizational skills
• Ability and willingness to learn and follow direction in a fast-paced call center environment
• Ability and desire to handle 25-30 calls per day. Adherence to specific work schedule is required
• Works well in a fast-paced environment
• Team culture a must
• Positive Attitude and ability to work in a team setting
• High level of patience
• Telephone courtesy
• Attention to detail
• Willingness and ability to learn
• Ability to work independently within specified time constraints
• Excellent punctuality and attendance required
• Ability to adapt and perform duties efficiently when unexpected changes arise
• This position will work non-traditional hours to achieve coverage during periods where training or extended call center operations are required