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

NCC Talent Solutions, LLC

Head of Quality Assurance Job at NCC Talent Solutions, LLC

 ...startup in San Diego to identify a Head of Quality who will play a critical leadership...  ...of Quality , you will lead the Quality Assurance organization and serve as the primary QA...  ...with aseptic processing. Strong working knowledge of bioprocessing, manufacturing... 

Driscoll Children's Hospital

Pediatric Nephrologist Job at Driscoll Children's Hospital

 ...Pediatric Nephrology Driscoll Childrens Hospital The Driscoll Health System is seeking a Pediatric Nephrologist to join a robust program engaged in providing the highest standard of patient care for the children of South Texas. We have an openings at both our Corpus... 

CarMax

Production Manager Job at CarMax

General Summary: The Service Operations Support Manager in Training is accountable for performing the job duties and responsibilities below, which primarily involve managing and leading associates. Principle Duties and Responsibilities: Manage and lead associates...

Dynamics ATS

Warehouse Associate Job at Dynamics ATS

 ...May assist with over-the-counter sales Skills Required Basic computer skills Must have stock picker/cherry picker and forklift experience of at least 3 years Education/Training/Certifications ~ High School Degree or Equivalent Additional Requirements... 

PRIMROSE HOSPICE CARE INC.

Hospice Medical Social Worker Job at PRIMROSE HOSPICE CARE INC.

Company Description Primrose Hospice Care is a compassionate care organization founded by healthcare providers committed to placing patients, families, and care teams at the center of hospice care. Our approach prioritizes personalized, flexible, and holistic methods ...