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

OHpJeEJsdXFDcGl5ZjRnbWdRR2NneWs4NkE9PQ==
  • 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

Peterson Consulting Group

Project Manager - WTP/WWTP - Up to $220+ Per year! Job at Peterson Consulting Group

 ...NEW HEIGHTS WITH A NEW OPPORTUNITY TO EARN BIG BONUSES! Project Manager/Project Engineer in the WTP/WWTP construction industry with a company...  ...a Superintendent/Assistant Project Manager/Project Engineer in water treatment facility construction ~ Experience with various... 

Vaco by Highspring

Digital Marketing Project Manager Job at Vaco by Highspring

 ...client located in Brentwood, TN is seeking a Digital Marketing Project Manager to join their team on a hybrid basis (4 days week in-office...  ...week ~ Experience with search engine optimization and pay-per-click advertising strategies ~ Comfortable analyzing web... 

LHH

Receptionist Job at LHH

 ...records. Provide support to other departments as needed. Qualifications: High school diploma or equivalent. Previous experience in a receptionist or customer service role preferred. Excellent communication and interpersonal skills. Strong... 

The Walt Disney Company

Entertainment Rigger/Stage Hand Job at The Walt Disney Company

 ...are ready to create unforgettable experiences and grow as a person and as a professional, apply today.As Entertainment Rigger and Stage Hand you will move and spot stage scenic elements during our Broadway/West End Style Musical Theater Productions and be responsible... 

Turning Stone Enterprises

Recycling and Sustainability Coordinator Job at Turning Stone Enterprises

 ...considering full-time, part-time, and contract positions for this role. The Recycling and Sustainability Coordinator will be responsible for supporting, developing and implementing solid waste sustainability and recycling initiatives for the Oneida Indian Nation and...