People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever change and business sustainability.

Imperial Health Plan of California, Inc. is approved by California Department of Managed Health Care to offer full-service Medicare Advantage coverage, including a Medicare Advantage Prescription Drug plan, and a Chronic Condition Special needs plan over numerous counties in California. Through its affiliate, Imperial Insurance Companies, Imperial also offers Medicare Advantage plans in Texas, New Mexico, Utah, and Arizona.

Our Mission: To deliver valuable care so that members are healthy in body, mind, and spirit to achieve their inherent potential.

Our Vision: To deliver value based care that is clinically effective, sustainable, and achieves exceptional outcome.

THIS IS IN-OFFICE - NO REMOTE IS AVAILABLE

JOB DUTIES:

Under general supervision, following established procedures, assist and direct patients and or providers in an empathetic and caring manner, efficiently and timely, and complete appropriate documentation. Respond to patient inquiries and attempt to resolve patient concerns or refer to management for resolution.

ESSENTIAL JOB FUNCTIONS:

• Answers phone calls and written questions, concerns, and complaints to include, but not limited to: members, providers, health plan, insurance brokers, and hospitals in accordance with HIPAA guidelines.
• Comply with member service policy and procedures.
• Assist in identifying and solving member/agent needs, issues and inquiries.
• Document accurately all inquiries in the plans databases(s).
• Ability to communicate to member needs for services using insightful, probing questions and demonstrates superior listening skills.
• Ability to give member eligibility and provides benefit related information to members and/or providers.
• Ability to communicate with contracted providers about turn around times, portal access, benefits and all other information as needed.

EDUCATION/EXPERIENCE:

· High school graduate or equivalent.

· 1-year customer service experience required

· 1-year experience dealing with high volume of calls and e-mails

· 1-year healthcare related experience in managed care environment to include but not limited to IPA, MSO or Health Plan

· Must be able to Type 40 or more WPM

· Bilingual English and Spanish preferred

SKILLS/KNOWLEDGE/ABILITY:

· Prefer knowledge on HEDIS and Risk Adjustment

· Microsoft Word and Excel

Job Type: Full-time

Pay: $21.00 - $22.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Pasadena, CA 91106: Reliably commute or planning to relocate before starting work (Preferred)

Experience:

• health care: 1 year (Preferred)

Work Location: In person

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