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

Alpha Youth Sports

Club/AAU Basketball Team Coach Job at Alpha Youth Sports

The Blazers Basketball Club (owned by Alpha Youth Sports and based in Southborough, MA) has become one of the most respected clubs in the MetroWest and Central MA areas. To support our growth, w e are hiring Head and Assistant Coaches for our Club/AAU Basketball teams...

University of Rochester

Opto-Mechanical Technician Job at University of Rochester

 ...Job Opening: Opto-Mechanical Technician, University of Rochester, Laboratory for Laser Energetics Division: Operations Group: XOPS Location: Rochester, NY The University of Rochesters Laboratory for Laser Energetics (LLE) is seeking an Experimental Operations... 

Cascade Contracting & Services, LLC.

Security Guard Job at Cascade Contracting & Services, LLC.

 ...Cascade Contracting & Services is currently looking to hire a Security Guard on a full time, permanent basis. This position must be performed onsite at Joint Base Pearl Harbor Ford Island in Honolulu, HI and requires the ability to obtain and maintain a Public Trust... 

Premiere Roofing

Foreman Job at Premiere Roofing

 ...Were currently hiring a Foreman to oversee roofing and construction projects from start to finish. This hands-on role includes supervising contractors and crews, ensuring quality workmanship, and maintaining strong, professional communication with customers on-site.... 

365 Yachts Sales

Senior Florida Licensed Yacht Broker Job at 365 Yachts Sales

 ...Tailored Experiences. Because Excellence is a Lifestyle. Role Description Join the Elite: Senior Level Licensed FL Yacht Broker Opportunity at 365 Yachts Location: Remote Industry: Luxury Yacht Sales Compensation: Industry-leading commission +...