Member Experience Representative, Bilingual (Mandarin or Cantonese)

Workforce Opportunity Services•Chandler, AZ

15h•$22 - $24•Onsite

About The Position

The Member Experience Representative works in a contact center supporting senior members covered by Medicare Advantage plans. The role involves communicating with members and, in some cases, physicians, providers, insurance brokers, family members, and caregivers through phone, email, other written channels, and in-person conversations. Representatives also document and service member needs in company software systems, requiring strong multitasking skills. The representative provides customer service by addressing questions and concerns about enrollment, claims, benefit interpretation, and referrals and authorizations for medical care. The role includes answering and directing calls and written inquiries, educating members and others about benefits and plan options, and following up on issues through resolution. The position is full-time, 40 hours per week, Monday through Friday, 9:00 a.m. to 6:00 p.m. It is on-site in Chandler, Arizona, with occasional travel for meetings and training.

Requirements

Fluency in English and Vietnamese.
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 remain 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 location.

Nice To Haves

Experience in the healthcare, insurance, or pharmacy industry.

Responsibilities

Provide excellent customer service.
Accurately explain benefits and plan options in person, by email, or by phone to members, family members, providers, and caregivers.
Follow up with members by clarifying issues, determining their causes, identifying resolutions, and explaining solutions.
Escalate member issues to management or other departments as required.
Meet or exceed departmental quality, productivity, schedule-adherence, and attendance standards.
Respond promptly to members, internal staff, and providers through phone, omnichannel interactions, and in-person discussions about 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.
Increase 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 regulatory requirements and HIPAA requirements.
Document interactions by completing member forms and summarizing actions taken in the computer system according to department standards.
Work with other departments as needed.
Meet attendance, schedule-adherence, and individual performance goals, including call quality and attendance.
Perform other duties as assigned.