Member Service Representative (Bilingual - Vietnamese, Korean, Spanish, or Chinese) Job at Astiva Health, Inc, Orange, CA

d0lGYWlJQkVjTzYzcUhhbU85ZzBlMjJlTkE9PQ==
  • Astiva Health, Inc
  • Orange, CA

Job Description

Job Title: Member Service Representative (Bilingual - Vietnamese, Korean, Spanish, or Chinese)

Target Compensation Range: $25.00-$28.00/hour, depending on the level of relevant qualifications and experience.

About Us:

Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members.

SUMMARY: The Member Service Specialist is responsible for answering telephonic inquiries from current and potential members and providers regarding Medicare Advantage benefits, eligibility, enrollment, claims, referral, prior authorizations, appeals & grievances and other related concerns. Our Member Service Specialists ensure customer satisfaction by providing excellent customer service, displaying a desire to help and maintaining a professional demeanor. Member Service Specialists will be expected to maintain quality and performance standards.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

  • Handle inbound and outbound phone calls, emails and other necessary communications with members and providers
  • Clearly identify and act on customer needs to achieve satisfaction.
  • Clearly explain all details of the Medicare Advantage Plan including procedures, protocols, benefits, and any other necessary information to the member or provider during inbound and outbound calls.
  • Fully understand all aspects of Medicare Advantage including but not limited to benefits, prior authorization, referrals, claims, enrollment, eligibility, appeals & grievances, providers networks and pharmacy services.
  • Provide accurate and complete information using the tools provided
  • Keep detailed written records of each telephone encounter during the call
  • Adhere to all call center metrics as set forth by CMS regulation and call center leadership.
  • Attempt to resolve the member’s issue completely during the first phone call.
  • Go above and beyond to provide exceptional customer service.

EDUCATION and/or EXPERIENCE:

  • 2+ years customer service experience
  • Minimum 1+ years’ experience with Medicare Advantage
  • Health Plan experience.
  • Excellent verbal and written communication skills including active listening and probing techniques.
  • Ability to multi-tasks, time manage and prioritize.
  • Ability to document information while on the phone with the member.
  • Ability to build rapport with members
  • Fluent in Spanish, Korean, Vietnamese, or Cantonese/Mandarin (verbal and written)

BENEFITS:

  • 401(k)
  • Dental Insurance
  • Health Insurance
  • Life Insurance
  • Vision Insurance
  • Paid Time Off

Job Tags

Similar Jobs

PTR Global

User Experience Designer Job at PTR Global

 ...fit those needs. Responsibilities Ensure that established design standards are consistently and appropriately applied within...  ...Design, or a related field of study ~3+ years' of experience in UX design ~ Proficient in visual design and wireframing tools... 

Find Great People | FGP

Teller Job at Find Great People | FGP

 ...client in Simpsonville is looking to hire a Teller to join their team. This role processes...  ...candidate will have previous related experience, an ability to complete transactions...  ...position. Prior experience in a retail banking environment is highly preferred. Responsibilities... 

AMMEGA

Senior Production Supervisor Job at AMMEGA

As a Senior Production Supervisor, you will coordinate, organize and control production within the manufacturing unit. This position serves as backup to the Production Manager to ensure efficient production of goods and services to achieve efficiencies in quality, safety...

Dillard's

Textile CAD Fashion Designer (Men's RTW) Job at Dillard's

 ...Job Purpose and Scope The Textile CAD Designer supports the Design Team in creating innovative prints, yarn dyes, jacquards, and embroideries for both in-house and private label brands. This role is responsible for producing production-ready artwork, managing textile... 

White City Logistics

OTR semi truck CDL class A driver Job at White City Logistics

 ...Semi truck driver with CDL class A We are OTR company and we need drivers to stay at least 3 weeks on the road before home time you should have minimum 2 yrs of verified OTR experiance. No ACCIDENTS or MAJOR VIOLATIONNS! Owner operators with there own trucks should...