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

PTR Global

Warehouse Specialist Job at PTR Global

 ...Warehouse Specialist Job Type: Temporary, Fulltime / Part-time Pay Rate: $15.00-20.00 hourly Location: Columbia Maryland...  ...hours of 8:00 AM to 4:00 PM, with the possibility of overtime and weekend shifts as needed. Responsibilities: Efficiently... 

Tex Tech Industries

Supply Room Attendant Job at Tex Tech Industries

Supply Room Clerk Summary: The supply room clerk maintains inventory of spare parts for the plant. The position is a M F, 8am 4pm, 40 hour/week job with occasional overtime required. Must be a U.S. Citizen, as this job is within a Secured Facility. Duties...

Mobilelink

Director of Loss Prevention Job at Mobilelink

 ...Conduct routine safety audits and provide solutions that make every location safer Ensure security systems (CCTV, alarms, access controls) are fully operational and reliable Collaboration & Reporting Collaborate with field and corporate leaders to align LP strategy... 

Hitachi Global Air Power

Human Resources Business Partner Job at Hitachi Global Air Power

 ...semiconductor chips. Our portable compressors provide the air power to build roads and bridges, lay pipelines and aid in oil and gas mining and production. We are a team of innovators, engineers, and quality experts with a shared vision to create the next generation... 

Creative Financial Staffing

Property Accountant Job at Creative Financial Staffing

 ...Property Accountant - Real Estate Management & Investment Firm Excellent Culture | Profit Sharing | Career Growth Our client, a respected and fast-growing company in real estate management and investment , is seeking a Property Accountant to join their expanding...