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: MondayFriday, 8:00 a.m.5:00 p.m.Pay rate: $24.00/hr - $33.50 per hour DOE
Key Responsibilities
Youll 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. #D800