L.A. Care Health Plan Enrollment Support Services Representative in Los Angeles, California

DUTIES The Enrollment Support Services (ESS) Representative is responsible for facilitating targeted enrollment activities and increasing membership in Cal MediConnect, Medi-Cal, L.A. Care Covered, and L.A. Care Covered-Direct. The primary duties for this position include, but are not limited to:

  • Meeting minimum production goals;

  • Maintaining expertise in eligibility, enrollment process, and program specifications in CISCO, QMEIS, MEIS, QNXT, PDM, MARx, Member360, and AEVS for all lines of business while maintaining strict compliance with DMHC and DHCS guidellines for all lines of business;

  • Handling inside/in-bound telephone inquiries from prospective members, providers, and other community partners seeking information regarding all lines of business;

  • Conducting outbound calls relevant to enrollment campaigns, requests for information from community events, provider offices, after-hour messages, and website inquiries;

  • Providing assistance to external insurance Agents and General Agencies regarding membership, commission, verification of eligibility, and other services, as requested; acting as outward facing support for contracted General Agencies;

  • Ensuring that information and assistance provided is within the standards established by all applicable federal /state laws and regulations and L.A. Care's Regulatory Affiars & Compliance Department;

  • Documenting and tracking pre and post enrollment activities via the Customer Relationship Management (CRM) system;

  • Supporting other projects within the Sales and Marketing Department as directed by the Management Team;

  • Providing external event coverage for community health fairs and enrollment events.

QUALIFICATIONS & REQUIREMENTS EDUCATION Required: High School Diploma

Preferred: High School Diploma

LICENSES/CERTIFICATIONS Preferred: Current California Life & Health License AHIP certification Covered CA Certification Medicare Training Certification

EXPERIENCE 2 years of customer service/telesales experience. Must have experience with customer relations and support. Excellent interpersonal and client interaction skills with strong attention to detail and accuracy; must possess good writing skills and calm/professional telephone presence. Ability to multi-task; flexible and comfortable working in a fast paced environment and committed to meeting deadlines. Great attitude, energy and enthusiasm are critical. Direct sales or related experience, preferably in the Medi-Cal, Healthy Families, Commercial, or Medicare Managed Care industry. Demonstrates general knowledge of Microsoft Word, Excel and Outlook

NOTE: Covered California Certification; California Department of Insurance License - Life & Health must obtain within 90 days with AHIP certification; ability to pass Medi-Cal Certification, and Medicare training certification.

Job Title: Enrollment Support Services Representative

Job Category: Administrative & Business Professionals

Department: Product Sales

Location: Headquarters, Downtown Los Angeles

Position Type: Full-time

Position Control Number: 1249

Pay Grade: E