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

SWFncFZkZ1JKSGl0SGdPTXNTZXZ6OHdT
  • 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

Hays

Project Manager Job at Hays

Job Title: Construction Project Manager Location: Palm Beach County About the Role We are seeking an experienced Construction Project Manager to oversee commercial construction projects ranging from $1M to $15M. This role is ideal for a results-driven professional...

Ventures Unlimited Inc

Mendix Developer Job at Ventures Unlimited Inc

Job Description Must Have Technical/Functional Skills: Minimum 8 years of professional Mendix development experience Hands-on development experience in Mendix Low-Code Platform for building enterprise-grade applications. Mendix Advanced Certification Proven...

Taylor Farms

Production Scheduler Job at Taylor Farms

 ...PRODUCTION SCHEDULER Essential Duties Evaluating sales orders, inventory, and delivery schedules to create production schedules. Forecast production amounts to ensure product availability for short lead time orders. Creating work orders used to estimate the... 

ACCIONA Energía

Regional Safety Specialist Job at ACCIONA Energía

 ...skills. Proficiency with LMS platforms and audit reporting tools; Maximo is a plus. Valid drivers license and ability to travel 40% (U.S. & Canada). ~ Spanish or French fluency is a plus. Eco Grove Wind Farm / High Point Solar Farm 9370 N. Baker... 

United Airlines

Engineer - Flight Operations Engineering and Analysis (Remote) Job at United Airlines

 ...next with us. Let's define tomorrow together. Get ready for a career at the leading edge of the airline industry! Our Flight Operations Engineering team works hard to connect people and unite the world safely, reliably and efficiently every single day. From industry...