Member Services Representatives - Medicare (Short Term ...

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.Hourly rate: $23.00/HRHandle 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 department’s 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).Bilingual Position: Coordinate telephonic translation of calls when Members do not speak English or SpanishOff phone workQA ReviewOne on OneProjectsMeetingsAny other duties as required to ensure Health Plan operations are successfulEnsure the privacy and security of PHI (Protected Health Information) as outlined in IEHP's policies and procedures relating to HIPAA complianceEducation & Requirements Experience Requirements:Two (2) years of HMO or Manage Care customer service experience analyzing and solving customer problemsHigh school diploma or GED requiredThis 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 QualificationsKnowledge of Medicare managed care is preferredKnowledge of Medical terminology, and Medi-Cal managed care is requiredUnderstanding of and sensitivity to multi-cultural communityProficiency in Microsoft Office Suite; high level capacity to multitaskExcellent multi-tasking skills. Typing 35 words per minute, proficient in Windows applications, and experience in data entryKnowledgeable of with the following programs: Cisco Finesse, Verint, HSP, MicrosoftExcellent written and verbal communication and interpersonal skillsStrong organizational skillsAbility and willingness to learn and follow direction in a fast-paced call center environmentAbility and desire to handle 25-30 calls per dayAdherence to specific work schedule is requiredWorks well in a fast-paced environmentTeam culture a mustPositive Attitude and ability to work in a team settingHigh level of patienceTelephone courtesyAttention to detailWillingness and ability to learnAbility to work independently within specified time constraintsExcellent punctuality and attendance requiredAbility to adapt and perform duties efficiently when unexpected changes ariseThis position will work non-traditional hours to achieve coverage during periods where training or extended call center operations are requiredPosition is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approvalAll IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadershipStart your journey towards a thriving future with IEHP and apply TODAY!Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)USD $23.00 - USD $23.00 /Hr.

Created: 2025-11-03