Medi-Cal Member Enrollment- Program Assistant

Published: 6/14/2022

Education

Job Description

Johnson Service Group (JSG) is hiring a Member Enrollment – Program Assistant for an on-site assignment supporting the Premium Billing & Member Enrollment team for a Health Plan partner in Orange County, CA.

Work schedule: Monday–Friday, 8:00 a.m.–5:00 p.m.

Pay rate: $24.00/hr. - $33.50 per hour DOE

• Expected Assignment Duration: up to six (6) months.

Key Responsibilities
You’ll support day-to-day program operations and help keep enrollment processes accurate, compliant, and member-focused, including:

Coordinating specialized enrollment processes (e.g., eligibility analysis, provider assignments, age restrictions, complex condition monitoring, and floor audits for the Medi-Cal program)
Assisting with member requests such as health network changes, PCP change requests, and data correction forms
Interpreting policies/regulations and responding to questions
Preparing letters/surveys and coordinating data files (including mail merges)
Documenting workflows, desktop procedures, and policies to support compliance
Creating reports and tools; performing reconciliations using Excel and Access (sorts/merges, filters, compiling reports, database procedures)
Supporting quality audits related to PHI/AOR and acceptance letter updates
Conducting outreach to members, and to health insurance carriers to verify potential other health coverage (OHC)
Sorting and tracking returned mail and maintaining accurate logs

Must-Have Qualifications

High school diploma or equivalent
1+ year of eligibility and/or reconciliation experience (or equivalent combination of education/experience)

Nice-to-Have

Medi-Cal and/or health insurance experience
Experience in HMO/managed care settings
Customer service experience
Experience with DHCS/DMHC interactions and Medi-Cal practices
Bilingual in English and one threshold language (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese)

JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.

\nCompany Description

We offer medical, dental, vision, life insurance options, paid time off, 401(k), weekly pay, and more.

Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.

Company Description

Johnson Service Group, Inc. (JSG) is a North American leader in the staffing and consulting services industry, with over 40 years of experience investing in people and companies. We can be found locally in more than 30 offices throughout the United States and Canada. JSG continues to work diligently to offer our clients and candidates world-class service and diversified offerings to fit their evolving needs.\n\nWe offer medical, dental, vision, life insurance options, paid time off, 401(k), weekly pay, and more.\n\nJohnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.\n