Member Experience Representative, Bilingual (Vietnamese)

Workforce Opportunity Services•Chandler, AZ

5d•Onsite

About The Position

Workforce Opportunity Services (WOS) is hiring a bilingual Member Experience Representative to support senior members enrolled in Medicare Advantage plans. The role is based in a contact center and includes phone, email, other written, and in-person interactions with members, as well as occasional interactions with physicians, providers, insurance brokers, family members, and caregivers. Representatives use company software to document and service member needs while handling multiple interactions and tasks. The representative provides customer service and education regarding enrollment, claims, benefits, plan options, eligibility, referrals, and authorizations for medical care. The role involves investigating and resolving member concerns, following up on issues, coordinating with providers and other departments, and escalating matters when appropriate. Representatives must follow department policies and job aids, regulatory requirements, and HIPAA requirements while meeting quality, productivity, attendance, and schedule-adherence expectations. This is a full-time, on-site position in Chandler, Arizona, scheduled Monday through Friday, 9:00 a.m. to 6:00 p.m. Occasional travel for meetings and training is required. The listed pay range is $22.00–$25.00 per hour, plus benefits.

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 in Chandler, Arizona.

Nice To Haves

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

Responsibilities

Provide excellent customer service to members.
Explain benefits and plan options accurately in person, by email, and 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 in a timely manner to members, internal staff, and providers through phone, omnichannel, and in-person interactions about benefits, eligibility, referrals, claims, and other issues, following policies, procedures, and job aids.
Take ownership of member issues and focus on solutions and options 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 to support efficient and compliant operations.
Suggest improvements and report workflow problems through the 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 and schedule-adherence expectations and individual performance goals, including call quality and attendance.
Perform other duties as assigned.