Member Experience Representative, Bilingual (Spanish)

Workforce Opportunity Services•Chandler, AZ

2d•$20 - $22•Onsite

About The Position

Workforce Opportunity Services (WOS) is a 501(c)(3) nonprofit that develops the skills of high-potential individuals and connects talent with organizations. The Member Experience Representative works in a contact center supporting senior members covered by Medicare Advantage plans. The role may also involve interaction with physicians and other providers, insurance brokers, members’ caregivers, and members in person. Work includes phone calls, email, other written channels, and in-person conversations, alongside documenting and servicing members in company software systems. The representative provides customer service by responding to questions and concerns about enrollment, claims, benefits, referrals, and authorizations for medical care. The role explains benefits and plan options, follows up to resolve member issues, and coordinates with providers and internal departments as needed. The position is full-time, 40 hours per week, Monday through Friday, 9:00 a.m. to 6:00 p.m., and is on-site in Chandler, Arizona. Occasional travel for meetings and training is required. The listed pay range is $20.00–$22.00 per hour, plus benefits.

Requirements

Fluency in English and Vietnamese, as specified in the qualifications.
High school diploma or equivalent.
1 to 2 years of call center or related customer service experience.
1 to 2 years of experience with Medicare benefits, including Medicare Advantage plans.
Ability to stay calm in charged situations.
Data-entry and general computer skills.
Effective written and oral communication skills and a professional, pleasant telephone manner.
Ability to handle high call volume while providing excellent customer service, with a record of efficiency in a high-volume environment.
Ability to commute reliably to the on-site workplace in Chandler, Arizona.

Nice To Haves

Experience in the healthcare, insurance, or pharmacy industry is highly desirable.

Responsibilities

Provide excellent customer service.
Explain benefits and plan options accurately in person, by email, or by phone to members, family members, providers, and caregivers.
Follow up with members by clarifying issues, determining causes, identifying resolutions, and explaining solutions.
Escalate member issues to management or other departments as required.
Meet or exceed departmental standards for quality, productivity, schedule adherence, and attendance.
Respond promptly to members, internal staff, and providers through phone, omnichannel, and in-person interactions concerning benefits, eligibility, referrals, claims, and other issues, following policies, procedures, and job aids.
Take ownership of issues and focus on solutions and options for members through resolution.
Improve member satisfaction by efficiently and accurately following up on and resolving issues, complaints, and questions, coordinating with providers and other departments as needed.
Participate in member calling projects assigned by management, such as membership retention.
Follow policies, procedures, and job aids; suggest improvements and report workflow problems through proper channels; participate in staff meetings and training.
Follow applicable federal and state regulations and HIPAA requirements.
Document interactions by completing member forms and summarizing actions in the computer system according to department standards.
Work with other departments as needed.
Meet attendance and schedule-adherence expectations and individual performance goals, including call quality and attendance.
Perform other duties as assigned.