Member Services Coordinator - Chinese

The job overview for the Member Services Coordinator role is to assist and respond to Medicare members' requests, questions, and concerns in a timely and professional manner. They will serve as a liaison between the Central Health Medicare Plan, members, and contracted IPAs/providers. The coordinator will provide general telephone customer service assistance, maintain accurate documentation of member interactions, and handle member enrollment and disenrollment processes. They will also be responsible for coordinating the intake of member grievances, appeals, and general complaints, ensuring timely filing and resolution.

• Assist and respond to all Medicare members' requests, questions, and concerns in a timely and professional manner
• Function as a liaison/service coordinator between Central Health Medicare Plan, members, and contracted IPAs/providers
• Provide general telephone customer service assistance to MAPD and DSNP members and providers
• Inform the Member Services Supervisor of any questions or issues encountered over the phone with members
• Assist with contacting/faxing provider offices when appropriate
• Check all voicemails and emails timely
• Write detailed and precise member phone log for each call received and called out
• Assist with member enrollment and disenrollment outbound contact/research and maintenance of member files
• Coordinate the assembling and mailing of welcome packets, ID cards, and all other applicable letters/notices to members
• Identify and research issues and requests of current members
• Assist with D-SNP member calls as appropriate
• Responsible for the intake of member grievances, appeals, coverage determination, and general complaints
• Coordinate with the handling Level 3 Coordinator and/or Member Services Supervisor in ensuring the timely filing of all cases
• Be familiar with Department P & P, Plan benefits, internal guidelines, and applicable CMS regulatory references
• Responsible to complete and handle assigned logs, tasks, member related surveys, and assist with all department projects as needed
• Assist Community Outreach and Education Department and Wellness Centers with event RSVP and other tasks.

• Be at work/cubicle timely based on the work schedule on file and ready to handle incoming customer calls and assignments professionally
• Provide general telephone customer service assistance to both MAPD and DSNP members and providers in a professional manner and provide precise and timely responses
• Assist with contacting/faxing provider offices when appropriate as part of the general assistance
• Check all voicemails and emails timely
• Write detailed and precise member phone log for each call received and called out and all department-assigned functions that require documentation
• Assist with member enrollment and disenrollment outbound contact/research and maintenance of member files
• Coordinate the assembling and mailing of welcome packets, ID cards, and all other applicable letters/notices to members when needed
• Identify and research issues and requests of current members and communicate clearly and concisely based on current policies and guidelines
• Assist with D-SNP member calls as appropriate and provide available resources
• Responsible for the intake of member grievances, appeals, coverage determination, and general complaints expressed verbally or in writing
• Coordinate with the handling Level 3 Coordinator and/or Member Services Supervisor in ensuring the timely filing of all cases
• Be familiar with Department P & P, Plan benefits, internal guidelines, and applicable CMS regulatory references
• Responsible to complete and handle assigned logs, tasks, member related surveys, and assist with all department projects as needed
• Assist Community Outreach and Education Department and Wellness Centers with event RSVP and other tasks as required.

• Health benefits
• Life and disability benefits
• 401(k) savings plan with match
• Up to 21 days of PTO
• 10 paid holidays, plus 2 floating holidays per year
• Lifestyle spending account