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

OEQ0eUNsdXVCcHV6ZVlFdGdBYVZqeVExN2c9PQ==
  • 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

Scouting America

Program Assistant Job at Scouting America

 ...related experience resulting in acceptable proficiency levels in the above Minimum Qualifications is an acceptable substitute for the above-specified education and experience requirements. Preference Prior experience using Forecaster and PeopleSoft is preferred.... 

Wind River Environmental LLC

Diesel Mechanic Job at Wind River Environmental LLC

 ...Monroe, CT Our Mechanics are the backbone of our fleet. As such they perform preventive maintenance and repairs to our fleet of trucks and equipment to ensure our vehicles are ready to service our customers! Position Summary Based out of our Monroe CT facility... 

Greystar

Property Accountant Job at Greystar

 ...fully integrated global real estate company offering expertise in property management, investment management, development, and...  ...JOB DESCRIPTION SUMMARY This role applies generally accepted accounting principles (GAAP) to analyze financial information, reconcile... 

Partners Personnel

Closing Coordinator Job at Partners Personnel

Job Title: Closing Coordinator Job Type: Full-time About the Role: We are seeking a highly organized and detail-oriented Closing Coordinator with a strong background in residential real estate transactions. The ideal candidate will have hands-on experience managing...

Akerman LLP

Real Estate Associate Job at Akerman LLP

The Tallahassee office of Akerman LLP seeks an Associate with 1 to 4 years of experience in commercial real estate transactions, including leasing (SNDA agreements and estoppel certificates), acquisition and sales transactions (purchase and sale agreements, due diligence...