Now Hiring - Membership Representative in Pasadena, CA

People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever change and business sustainability.

Imperial Health Plan of California, Inc. is approved by California Department of Managed Health Care to offer full-service Medicare Advantage coverage, including a Medicare Advantage Prescription Drug plan, and a Chronic Condition Special needs plan over numerous counties in California. Through its affiliate, Imperial Insurance Companies, Imperial also offers Medicare Advantage plans in Texas, New Mexico, Utah, and Arizona.

Our mission: To deliver valuable care so that members are healthy in body, mind, and spirit to achieve their inherent potential.

Our vision: To deliver value based care that is clinically effective, sustainable, and achieves exceptional outcome.

THIS IS IN-OFFICE - NO REMOTE IS AVAILABLE

JOB SUMMARY: Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received via call tracking, claims, or e-mail in order to retain existing members. Maintain records in the enrollment database. Establish and maintain a business relationship with new and existing sales representatives and/or brokers using strong interpersonal and relationship-building skills.

ESSENTIAL JOB FUNCTIONS:

1. Answers phone calls and written questions, concerns, and complaints regarding membership.

2. Daily data entry of enrollment applications in the member database M360.

3. Processes provider-member termination and issues notices.

4. Provides information on membership fees (if applicable), policies, processes, benefits, products, and services.

5. Actively listens to members and identifying their needs and investigating and resolving membership and payment issues (as needed).

6. Assesses member eligibility and providing benefit related information to members and/or providers.

7. Documents all inquiries and maintaining accurate membership records in plans database(s).

8. Maintains knowledge levels with respect to CMS and states regulations

9. Ensuring that the relevant enrollment information is captured in Wipro M360.

10. Assist in identifying and solving member/agent needs, issues and inquiries.

EDUCATION/EXPERIENCE:

· High school graduate or equivalent.

· Customer service experience required

SKILLS/KNOWLEDGE/ABILITY:

· Understanding and knowledge of enrollment elections prior to enrollment submission to CMS.

· Knowledge of Retro Processing Contractor standard operating procedures.

· Knowledge of Chapter 2 Enrollment & Disenrollment.

· Good listening and interpersonal skills

· Excellent attention to detail

· Proficiency in common computer programs, such as Microsoft Word and Excel

· Work effectively as a member of a team

Job Type: Full-time

Pay: $19.00 - $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Pasadena, CA 91106: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Preferred)

Experience:

• Customer service: 1 year (Required)
• Microsoft Word: 1 year (Required)
• Microsoft Excel: 1 year (Required)

Work Location: One location