Member Experience Representative, Bilingual (Vietnamese)

Workforce Opportunity Services•Huntington Beach, CA

5d•Onsite

About The Position

Workforce Opportunity Services (WOS), a 501(c)(3) nonprofit, is hiring a bilingual Member Experience Representative to support senior members covered by Medicare Advantage plans. The role operates in a contact center and also includes in-person interactions. Representatives communicate with members and, when needed, physicians, providers, insurance brokers, family members, and caregivers through phone, email, other written channels, and in-person conversations. The representative provides customer service and explains enrollment, claims, benefits, plan options, eligibility, referrals, and authorizations for medical care. The position requires balancing member interactions with documenting and servicing members in company software systems. Representatives take ownership of issues, identify solutions, follow up through resolution, and coordinate with providers and other departments. The role is full-time, on-site in Huntington Beach, California, Monday through Friday from 9:00 a.m. to 6:00 p.m., with occasional travel for meetings and training.

Requirements

Fluency in English and Vietnamese.
High school diploma or equivalent.
One to two years of call center or related customer service experience.
One to two 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 Huntington Beach, California location.

Nice To Haves

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

Responsibilities

Provide excellent customer service to members.
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 causes, identifying resolutions, and explaining solutions.
Escalate member issues to management or other departments when required.
Meet or exceed departmental standards for quality, productivity, schedule adherence, and attendance.
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 member issues and focus on solutions and options 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 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 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.