Customer Solution Center Enrollment Services Representative II
Found in: beBee jobs US - 2 weeks ago
Salary Range: $50, Min.) - $62, Mid.) - $75, Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
The Customer Solution Center Enrollment Services Representative II is responsible to audit, research, update and maintain the member data integrity in the core system such as provider and plan partner assignments, member demographics, troubleshoot complex issues, etc. for all lines of business. This position audits inbound eligibility file load errors, intake forms and e-mail requests; make recommendation or update member information and other related transactions as needed within the timeframe as outlined in the company policies and procedures. Collaborates with internal/external departments to ensure timely resolution to member issues and member access to care. Assists with user acceptance testing (UAT) related to system and/or process defects and issues. Provides support and ownership of any escalated and/or complex issues related to member coverage preventing from member access to care.
DutiesDaily audit inbound eligibility load errors, intake form and e-mail requests related to member coverage, provider and plan partner assignments, manual update to member demographic and other related transactions preventing member access to care. Support internal/external departments and make recommendation as needed.
Timely processing of work assignments and maintain accuracy of provider and plan assignments as outlined in the company policies and procedures.
Assist the department in user acceptance testing (UAT) to improve/enhance processes.
Assist the department in the development of desktop level procedure (DLP).
Perform other duties as assigned.
Duties ContinuedEducation Required
High School Diploma/or High School Equivalency CertificateEducation Preferred
Experience
Required:
Minimum 0-1 years member eligibility data experience in a healthcare environment.
Experience with and knowledge of Medi-Cal, Medicare, Market Place/Exchange, Commercial and Individual product lines and other related government-funded/sponsored healthcare programs.
Preferred:
Previous experience in Managed Health, preferably in Customer Service, Enrollment Services/or Claims.
Required:
Strong research, auditing, multi-tasking, problem-solving and verbal/written communication skills
Intermediate computer skills including MSOffice Suites as well as member processing system such as QNXT or MHC.
Preferred:
Knowledge in MARx and AEVS
Knowledge in 834, TRR, HCO or RTZ member eligibility electronic files.
Bilingual in one of LA Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.
Licenses/Certifications RequiredLicenses/Certifications Preferred
Required Training
Required:
Customer Service
LightAdditional Information
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
-
Customer Solution Center Enrollment Services Representative II
Found in: beBee jobs US - 4 days ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure...
-
Customer Solution Center Enrollment Services Representative II
Found in: beBee jobs US - 4 days ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Customer Solution Center Member Advocate II
Found in: beBee jobs US - 3 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $67, Min.) - $87, Mid.) - $107, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Customer Solution Center Appeal and Grievance Compliance Advisor
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five...
-
Customer Solution Center Even MORE Service Liaison I
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Supervisor, Customer Solution Call Center
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $67, Min.) - $87, Mid.) - $107, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Inside Sales and Retention Representative II
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Customer Solution Center Appeals and Grievances Specialist II
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $60, Min.) - $75, Mid.) - $91, Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure...
-
Customer Solution Center Appeals and Grievances Specialist II
Found in: beBee jobs US - 3 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $60, Min.) - $75, Mid.) - $91, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Customer Solution Center Appeals and Grievances Training Specialist II
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $77, Min.) - $100, Mid.) - $123, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Customer Solution Center Appeals and Grievances Specialist II
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five...
-
Medicare Advantage Enrollment Representative
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States UCLA Health Full timeAs a member of the Medicare Advantage Operations team, the Medicare Advantage Enrollment Representative plays a crucial role in the enrollment process by reviewing and submitting enrollment requests. This position requires meticulous attention to detail to ensure the accuracy and timeliness of acknowledgment notices sent to members. The ideal candidate will...
-
Call Center Representative
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States Med Metrix Full time[Customer Service / Remote] - Anywhere in U.S./ Competitive Pay - As a Call Center Rep you'll: Respond to patient inquiries, requests, and disputes over the phone by clarifying, researching, locating, and providing information; Process patient credit card payments over the phone to resolve outstanding self-pay balances; Act cooperatively and courteously with...
-
Customer Solution Center Appeals and Grievances Quality Auditing Specialist II
Found in: beBee jobs US - 6 days ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $67, Min.) - $87, Mid.) - $107, Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Manager, Customer Solution Center Appeals and Grievances
Found in: beBee jobs US - 3 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $88, Min.) - $115, Mid.) - $142, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Medicare Advantage Sr. Enrollment Representative
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States UCLA Health Full timeAs a member of the Medicare Advantage Operations team, the Senior Medicare Advantage Enrollment Representative plays a pivotal role in processing all enrollment, disenrollment, and cancellation requests. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to ensure accurate and timely processing. The...
-
Customer Solution Center Appeals and Grievances Quality Auditing Specialist II
Found in: beBee jobs US - 3 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $67, Min.) - $87, Mid.) - $107, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Customer Solution Center Appeals and Grievances Quality Auditing Specialist II
Found in: beBee jobs US - 1 week ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $67, Min.) - $87, Mid.) - $107, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Customer Solution Center Appeals and Grievances Coordinator I
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $47, Min.) - $57, Mid.) - $68, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Broker Services Specialist II
Found in: beBee jobs US - 2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $55, Min.) - $69, Mid.) - $82, Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure...