Job Description

Location: Bakersfield, CA (Onsite)

Classification: Full-Time

This position is non-exempt and will be paid on an hourly basis.

Schedule: Monday-Friday 8am-5pm

Benefits:

· Medical

· Dental

· Vision

· Paid Time Off (PTO)

· Floating Holiday

· Simple IRA Plan with a 3% Employer Contribution

· Employer Paid Life Insurance

· Employee Assistance Program

Compensation: The initial pay range for this position upon commencement of employment is projected to fall between $23.00 and $28.74. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.

Position Summary:

Coordinate the membership enrollment process for Universal Healthcare MSO’s health plan members to ensure all information is accurately recorded and processed in a timely manner, adhering to department guidelines. Responsible for reconciling membership data against capitation payments received from health plans.

Requirements

Job Duties and Responsibilities:

• Manage enrollment and eligibility files for all lines of business, ensuring accuracy and timeliness.

• Reconcile membership records with capitation payments from delegated health plans.

• Collaborate with health plans and employer groups to address and resolve enrollment inquiries or discrepancies.

• Verify member information, including Primary Care Physician assignments, effective dates, coverage details, termination dates, addresses, and plan benefits.

• Respond to general eligibility inquiries and provide exceptional customer service.

• Maintain and update eligibility records in the database to ensure accuracy and compliance with department standards.

• Assist Configuration teams, including Contracting and Provider Network Management, with tasks to support department objectives and deadlines.

Qualifications:

• Minimum of 3 years in an administrative role with relevant experience (e.g., office administration, insurance services, or customer service).

• High School Diploma or GED required.

• 3+ years of experience in the Managed Care or Healthcare industry preferred.

• Associate’s or Bachelor’s degree in Business Administration or a related field preferred.

• Certification in Healthcare Administration or Managed Care is a plus.

• Advanced Excel skills, including pivot tables, VLOOKUP, and data analysis, are highly desirable.

• Familiarity with process improvement methodologies (e.g., Lean, Six Sigma) is a plus.

• Strongly preferred: experience with health plans and insurance eligibility verification