Customer Service Representative Lead (Bilingual Mandarin)

Clever Care Health Plan • Arcadia, CA

8d • $26 - $31 • Hybrid

About The Position

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values. We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.

Requirements

• High school diploma or equivalent
• At least 3 years customer service experience, preferably in healthcare management and/or a call center setting.
• 1 of those years must be with an MAPD plan.
• At least 1 year experience in a supervisory or lead role, preferably in healthcare management and/or a call center setting.
• Bilingual in Cantonese, Mandarin, Vietnamese or Korean is required.
• Must pass comprehensive exam on Clever Care benefits and policies, as well as CMS guidelines.
• Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations
• Exceptional customer service skills, including verbal and written communication
• Strong active listening skills
• Ability to collaborate and be a team player
• Must be a quick learner
• Ability to remain calm and courteous when handling upset members and offering solutions to their problems and knowing when to escalate the call
• Ability to listen, talk, and type at the same time.
• Proficiency with Microsoft Office (Word, Excel, Outlook)
• Type 40 wpm. 60 wpm preferred.
• Must be able to travel when needed or required
• Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)
• Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.
• Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly.
• A background check is required.

Nice To Haves

• Bachelor’s Degree preferred.

Responsibilities

• Educates members, family, providers and caregivers regarding benefits and plan options.
• Accurately explains benefits and plan options in person, via email, or telephonically.
• Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution.
• Escalates appropriate member issues to management or other departments as required.
• Participates heavily in member calling projects as assigned by management to support the overall Clever Care goal of membership retention.
• Manages and maintains campaign success within their language pod.
• Follows policies and procedures and job aids in order to maintain efficient and complaint operations; communicates suggestions for improvement and efficiencies to management; identifies and reports problems with workflows following proper departmental procedures; actively participates in departmental staff meetings and training sessions.
• Follows all appropriate Federal and State regulatory requirements and guidelines applicable to Clever Care Health Plan operations, as documented I company policies and procedures.
• Follows all HIPAA requirements.
• Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.
• Onboarding and training new representatives from start to finish.
• Identify and actively drive training and development team changes, processes, staffing, and training needs.
• Performs inbound and outbound support for escalated callers via phone and email to de-escalate and manage challenging situations and circumstances.
• Closes gaps in care.
• Conducts telephonic enrollments for prospective members.
• Participates in various webinars and training offered by Medicare Learning Network, AHIP, etc. to further advance their knowledge.
• Represents the Member Service department at various in person events hosted by the Plan.
• Respond to inquiries sent through the customer service email and fax.
• Oversee the Member Services Team, providing direct coaching and feedback to ensure quality.
• Delegate tasks and set deadlines for the team.
• Assess the needs of the caller and determine, based on strong operational understanding, the most appropriate and effective course of action.
• Develop educational training material in language and organize and facilitate training sessions for new Member Advocates in language, as well as other departments within the company as related to member service.
• Facilitate in the development and achievement of language line based call measures within their own language pod, individually and collectively.
• Play an integral role in the hiring of Member Advocates as it relates to passing language requirements.

Benefits

• Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED