New

Member Services Representative - Open Enrollment

TEKsystems
$22.00 - $32.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, California, Concord
Jul 17, 2025
Role: Member Services Representative - Open Enrollment Time frame for completion: 40 hours/week on-site in Concord, CA (M-F 8 AM-5 PM PST) Description Description of work to be performed: Duties and Responsibilities: Performs various duties and responsibilities of Member Services Assistant and Member Services Assistant Lead. Communicates via telephone, in person and written correspondence, answers questions regarding the Plans' Benefits, eligibility, claims processing and claims appeal Obtains all pertinent information to determine specific purpose of call and/or walk-in. Writes an eligibility appeal, sick leave and/or basic medical appeal if necessary. Initiates and prepares correspondence and other documentation to resolve questions and provide information to members and others in accordance with Plans' rules, regulations, and practices. Initiates and reviews various applications, notices, forms, certifications, self-payments, COBRA, stop payments, clear claim notices. Identifies and corrects information on Computer system and/or refers to appropriate staff for correction. Determines eligibility in accordance with Plan rules and resolves eligibility issues and questions. Confirms or denies coverage based on eligibility rules of the member's plan. Maintains appropriate documentation of all calls & walk-ins. Handles walk-ins in a courteous and professional manner. Discerns needs and verifies forms from a walk-in and refers to appropriate personnel based on needs. Acts as liaison between member and provider to communicate plan benefits and facilitate claims processing. Calculates sick leave banks. Refers calls, members, union locals, and others to appropriate department. Assists with special projects as requested. Specified productivity speed/number of tasks/amount of material: Sample of Job Duties: Answering calls with Headset HIPAA Checks/Survey Offered Reference the Requirements based on Plan Level Kaiser Telephonic HIPAA Provider Eligibility calls Comprehend Enrollment Requirements/Options Carrier Changes Dependent Coverage Changes Other Insurance Information Updates Dependent Documentation (Birth Certifications/Marriage Certifications/Authorization to Deduct Form/Tax Form or Re-Occurring Household Bills) Comprehend Wellness Step Requirements/Options HCP Agreement Health Risk Questionnaire (HRQ) Biometrics PPO vs HMO Members along with Vaccination Card Requirements All items will be tracked in the member's profile. Skills* Call center, Data entry, Customer support, Inbound call, Microsoft office, open enrollment, Insurance, Customer service, Health care, Customer service call center, benefits verification, claims submission Top Skills Details Call center,Data entry,Customer support,Inbound call,Microsoft office,open enrollment Additional Skills & Qualifications High school diploma Strong communication skills and knowledge of grammar, spelling and simple mathematical functions like percentages, ratios, etc. Experience Level Entry Level Pay and Benefits The pay range for this position is $22.00 - $32.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Concord,CA. Application Deadline This position is anticipated to close on Jul 21, 2025. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.