Enrollment and Benefits Technician- Bakersfield 1.1

Universal Healthcare MSO•Bakersfield, CA

11h•Onsite

About The Position

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

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

Nice To Haves

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.
Familiarity with process improvement methodologies (e.g., Lean, Six Sigma) is a plus.
Experience with health plans and insurance eligibility verification is strongly preferred.

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.