Member Services Representative

Member Services Representative

Asian Health Services, founded in 1974, provides medical, dental, and behavioral health services to more than 50,000 patients. Our approach to well-being focuses on whole patient health for all. We go beyond our clinic walls and invest in our communitys overall health. We know that income, housing, and environmental struggles lie at the heart of poor health. Thats why we also address food insecurity, youth leadership, and culturally competent care while working towards supporting safer streets and vibrant communities.

LOCATION : HMC

JOB SUMMARY : With supervision from the Senior Member Services Manager, learns to determines initial and continuing eligibility for health and social services by screening and interview patients to assess financial payer sources and status.

Note : This role is grant funded through December 2026.

Essential Job Function - Patient Eligibility

• Conducts patient financial screening to determine eligibility for County Medical Services Program (CMSP), Medicare, Medi-Cal, Healthy Families, and other payment sources.
• Assists patients in completing forms and applications for payment programs. Follows up on patients pending status for payment programs.
• Assists patients in selecting a primary care provider and a health insurance plan, including PPO and HMO.
• Contacts health plan and insurance company to verify patients insurance coverage and referral requirement; may assist in completing Medi-Cal applications and perform status follow-up with the countys Medi-cal worker.
• Answers inquiries and provides counseling regarding Medi-Cal and Medicare and their managed care systems, and other social service needs.
• Update patient financial information in the computer system and follow up on patients pending status for a payment program,
• Answer incoming phone calls that are directed to the Member Services Department and make appointments for members.
• Assists the Member Services Manager in conducting member exit interviews and in processing monthly member rosters for all AHS contracted managed care plans.
• Provide input to Member Services Manager in developing and maintaining eligibility criteria and procedures consistent with AHS goals and objectives.
• Provides advocacy for AHS patients / members due to government welfare reform and immigration policies.
• Conduct medical history intake interviews for all patients including new patients, newborn infants, and perinatal patients.

Other Duties

Minimum Qualifications

Preferred Qualifications

Certifications, Licenses, Registrations

On-call employees does not qualify for company benefits.

$31.15 - $34.33 an hour

Compensation details : 31.15-34.33 Hourly Wage

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