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 an authentic experience! Thrill in the role of a Member Service Representative Medicare, championing Medi-Cal, Medi-Medi and Medicare Members to maximize benefits and achieve optimal health.
Navigate complex systems with expertise to guide members, answering inquiries about benefits, claims, and wellness programs.
Facilitate seamless access to in-network providers and collaborate across departments to meet members needs.
Experience the excitement of off-phone work, engaging in quality assurance reviews, one-on-one session, projects, and dynamic meetings! This is a Short Term Position that will last up to 6 months. *This position will not be eligible for benefits. This is a non-bilingual: bilingual preferred position.
Identified bilingual team members in this role must take a language proficiency assessment and must receive a passing score. Commitment to Quality: The IEHP Team is committed to incorporate IEHPs Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Handle Medi-Cal and Medicare Inbound CallsResponsible for covering the Cisco ACD Queue telephone lines.Meet IEHP and Member Services Call Center standard and policy requirements.Assist Members with many different process or benefit information such as:Members eligibility statusPrimary care/facility assignments, selections, and changesHealth program educationEnsures documentation is accurate and in compliance with regulatory requirements and accreditation standardsMaintain knowledge of other departments roles as they pertain to Member Services standard work processes, to ensure proper handling of callsEnsure key performance indicator goals are met monthly (Quality Assurance, AHT, Adherence).Coordinate telephonic translation of calls when Members do not speak English or SpanishOff phone work:QA ReviewOne on OneProjectsMeetingsEducation & 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 settingExternal Candidates: Two (2) years of HMO or Manage Care customer service experience analyzing and solving customer problemsThis is a non-bilingual: bilingual 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 preferredKnowledge of Medical terminology, and Medi-Cal managed care is requiredUnderstanding of and sensitivity to multi-cultural community *Hourly rate: $23.00/HR
Start your journey towards a thriving future with IEHP and apply TODAY! Telecommute USD $22.20 - USD $28.31 /Hr.