Member Services Representative Full-time Hybrid

Position Highlights:

• Fulltime Hybrid position 3 days remote/2 days in office
• Location: Los Angeles CA (candidate must be located in the metro area)
• Salary: $50000$65000 annually flexible for commensurate skills and experience
• Ability to positively impact the health and wellbeing of critical communities
• Generous compensation and benefits package

Company Overview:

Our Los Angelesbased client the Santa Monica Fund (the Fund is a startup nonprofit TaftHartley Trust Fund passionate about its mission to provide exemplary services in healthcare and benefits administration to its UNITE HERE! union members and their families. The Fund through its strategic partnership with MLK Community Healthcare is staffing and opening a new clinic and office in downtown Los Angeles to offer primary care and dental services sidebyside with benefits administration and support for planned expansion in the future. The Fund takes pride in their commitment to providing excellent affordable healthcare benefits to its members while ensuring member satisfaction operational efficiency and compliance. The team values diversity equity inclusion and justice (DEIJ) fostering a safe collaborative workplace where everyone can thrive. If youre passionate about growth making a meaningful impact and driving positive change join their mission to support their communitys wellbeing.

Position Overview:

The ideal candidate provides confidential highly responsive and accountable handson engagement with and support to SMF s membership. As a direct interface with the membership and a representative of the Fund provides benefits eligibility claims and healthcare education information support and issue resolution to this multicultural community. The MSR works collaboratively with the MSR team and the teams in Employer Services Health Promotion and Member Outreach to communicate the SMF message of engagement support care and education by encouraging the utilization of benefits according to the plan design and best healthcare value while optimizing the membership s experience with SMF.

What You Will Be Responsible For:

• Serves as the primary point of contact for SMF s membership on benefits eligibility claims healthcare education information support and questions.
• Receives and records walkin/inperson email and telephonic inquiries regarding plan benefits.
• Proactively establishes and maintains collaborative relationships with SMF s membership.
• Supports planning for and onboarding new membership enrollment activities and partners with Employer Services Health Promotion and Member Outreach on related activities for the membership including participation in healthcare programs.
• Researches benefits eligibility and claim issues and initiates corrective actions with relevant areas.
• Supports the maintenance of databases information systems programs processes policies procedures and forms/documents to ensure compliance and clarity. Provides ideas and recommendations for process and program improvements and enhancements of service delivery.
• Supports membership communications and required notices and filings are completed submitted and/or distributed in a timely compliant manner.
• Supports compliance with applicable health plan federal state and local regulations and standards (e.g. ACA HIPAA COBRA QMCSO SBC notifications communications etc..
• Supports establishing and maintaining procedures and controls to ensure accuracy efficiency productivity and regulatory compliance.
• Partners with Employer Services and the technical team to support the operational efficiency and effectiveness of the software platform.
• Partners with Employer Services to ensure that health planeligible members receive timely benefit coverage.
• Ensures efficient and effective processes and procedures so that the membership receives the highest level of service by providing accurate consistent and timely answers to inquiries through a problemsolving and resultsbased approach.
• Maintains uptodate knowledge of all systems and sources relating to plan benefits processes policies etc. that will affect the performance of daily tasks.

What You Bring to the Role:

• Bilingual (English/Spanish): Required.
• Experience Preferred:
  • Customer care and services including member education and outreach and healthcare enrollment activities and processes through telephonic email and inperson environments.
  • Healthcare insurance union health plans compliance and/or community outreach education and engagement.
  • Employee benefit plans and related governmental/legislative regulations (ERISA DOL IRC HIPAA ACA etc. including plan design and interpretation.
  • 1 years in a customer call center environment
  • 1 years of project management in a growthoriented environment.
  • Experience in a TaftHartley or collective bargaining environment is ideal.
• Skills
  • Detail and qualityoriented highly organized and effective issue resolution skills.
  • Experience in and working knowledge of information technology systems practices and tools including efficient utilization of document filing systems and filesharing across teams
  • Excellent listening and communication skills (written and verbal) including professionally written communications via documentation reports and presentations.
  • Strong team player with strong interpersonal capabilities and experience building relationships working and collaborating in teams.
  • Ability to conduct research compile and analyze data and create and distribute reports.
  • Strong ability to organize plan and manage competing deadlines as well as effectively multitask.
  • Proficiency in Microsoft Office Suite

Compensation Benefits and Job Structure:

This is a fulltime hybrid position requiring two days onsite and three days working from home subject to business needs. The salary range is $50000 to $65000 annually with overtime eligibility. The role offers a comprehensive and generous benefits package which becomes effective on the first of the month following 30 calendar days of active service. Benefits include $0 copremium medical dental vision and prescription coverage along with 401(k) pension life and AD&D insurance. Additional perks include paid time off comprising 12.5 holidays 3 personal days 7 sick days 5 bereavement days vacation days legal services and access to an employee assistance program.