Healthcare Benefits Coordinator

2 weeks ago


Palmdale, California, United States Blue Shield of California Full time
About the Role

This position is located at our Community Resource Center (CRC) in Pomona, California. As a CRC Representative, you will provide in-person support to Blue Shield Promise members and consumers who visit the CRC.

Your Responsibilities

Key responsibilities include:

  • Resolving issues and inquiries concerning member eligibility, benefits, provider information, clinical, pharmacy, and other health or social service needs.
  • Composing routine and non-routine correspondence to answer benefits/provider inquiries in writing.
  • Coordinating membership changes, such as primary care physician assignments.
  • Analyzing available programs, determining program eligibility, and connecting members to appropriate BSC vendors, Health Advocates, Social Workers, Pharmacy Techs, and Pharmacists.
  • Conducting outreach calls and activities to inform members about the Community Resource Centers, how to access health plan benefits, and assisting with scheduling appointments.
  • Verifying member inclusion in outreach or care gap programs and connecting members to programs or services when appropriate.
Your Qualifications

To succeed in this role, you will need:

  • At least 3 years of professional experience.
  • Broad knowledge of operational systems and practices typically gained through extensive experience and/or education.
  • Bilingual proficiency in Spanish, demonstrated by successful completion of an oral language proficiency test.
  • Experience with Medi-Cal enrollment guidelines, specifically Medi-Cal renewal/redetermination process.
  • A customer service background.
About Our Company

Blue Shield of California is a leading health plan that connects members to quality healthcare services. We are dedicated to improving the lives of our members and communities.

Benefits

We offer a competitive salary range of $20.47 to $28.66 per hour for this role, based on experience and qualifications. Additional benefits include opportunities for professional growth and development, a positive work environment, and a chance to make a meaningful impact in the lives of our members.



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