Member Services Representative

Position Highlights:

• ​​​​​​Full-time, hybrid position (3 days remote, 2 days in office).
  
• Location: Los Angeles, CA (candidate must be located in the metro area).
  
• Non-exempt, hourly wage: $24.0385~$31.2500 per hour ($50,000~$65,000 annualized) plus overtime eligibility, commensurate with experience and qualifications.
  
• Ability to positively impact the health and well-being of critical communities.
  
• Generous benefits package.
  

Company Overview:
Los Angeles-based, UNITE HERE Local 11 Benefits Administrative Office (the “Fund”) is a start-up, non-profit Taft-Hartley 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, side-by-side 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 you're passionate about growth, making a meaningful impact, and driving positive change, join their mission to support their community's well-being.

Position Overview:
The ideal candidate provides confidential, highly responsive, and accountable hands-on engagement with and support to the Fund’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 multi-cultural community. The MSR works collaboratively with the MSR team and the teams in Employer Services, Health Promotion, and Member Outreach to communicate the Fund's 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 the Fund.

What You Will Be Responsible For:

• Serves as the primary point of contact for the Fund's membership on benefits, eligibility, claims, healthcare education, information, support, and questions.
  
• Receives and records walk-in/in-person, 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 plan-eligible 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 problem-solving and results-based approach.
  
• Maintains up-to-date 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 in-person 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 growth-oriented environment.
  
• Experience in a Taft-Hartley or collective bargaining environment is ideal.
  

Skills

• Detail and quality-oriented, 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 file-sharing 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:
Full-time hybrid position (3 days remote, 2 days in office), subject to business needs. ​​​​​​Non-exempt, hourly wage of $24.0385~$31.2500 per hour ($50,000~$65,000 annualized) plus overtime eligibility, commensurate with experience and qualifications. Comprehensive and generous benefits package, which becomes effective on the first of the month following 30 calendar days of active service. Benefits include $0 co-premium 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.