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

WWxWdXdmb0Era1BSMnhGNGhOQTRiaklP
  • 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

Auctions at Showplace

Auction Photography Editor Job at Auctions at Showplace

 ...experience working with products. The role is situated within a fast-paced auction environment in Astoria, NY that processes thousands of lots of fine and decorative arts every month and is supervised by our Head of Photography Editing. Salary range: $22-$24 / hour... 

Staffmax Staffing & Recruiting

Data Entry Clerk Job at Staffmax Staffing & Recruiting

 ...working with our client to find a highly accurate and dependable Data Entry Clerk for a 3-month contract. If you have a keen eye for...  ...experience in a data entry or clerical role Proficient in Microsoft Excel and Google Sheets Ability to work independently and meet... 

Pampered Auto Transportation LLC

NEMT driver Job at Pampered Auto Transportation LLC

Company Description Pampered Auto Transportation is a non emergency medical transport company. We operate out of Muskegon Michigan and travel throughout the western section of Michigan. All along the lakeshore our vehicles transport clients in Ottawa County, Kent County...

Tiffany & Co.

Advanced Jewelry Designer Job at Tiffany & Co.

Tiffany & Co. seeks an Advanced Jewelry Designer in New York to ensure design integrity and aesthetic vision across high and fine jewelry projects. The role demands a BFA and over 5 years of experience, with a salary range of $101,575 - $137,425.

Altar'd State

Assistant Store Leader- Guest Experience Job at Altar'd State

 ...performance Co-conducts and facilitates sales associate and keyholder training Process ~ Engages our guests and make their shopping experience exceptional ~ Makes recommendations on hiring, promotions, and terminations of team members based on performance ~...