Member Service Representative

3 months ago

Orange, United States Astiva Health, Inc Full time

Job Title: Member Service Representative (Bilingual - Vietnamese, Korean, Spanish, or Chinese)

Target Compensation Range: $20.00-$25.00/hour, depending on the level of relevant qualifications and experience.


About Us:

Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members.


SUMMARY: The Member Service Specialist is responsible for answering telephonic inquiries from current and potential members and providers regarding Medicare Advantage benefits, eligibility, enrollment, claims, referral, prior authorizations, appeals & grievances and other related concerns. Our Member Service Specialists ensure customer satisfaction by providing excellent customer service, displaying a desire to help and maintaining a professional demeanor. Member Service Specialists will be expected to maintain quality and performance standards.


ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

  • Handle inbound and outbound phone calls, emails and other necessary communications with members and providers
  • Clearly identify and act on customer needs to achieve satisfaction.
  • Clearly explain all details of the Medicare Advantage Plan including procedures, protocols, benefits, and any other necessary information to the member or provider during inbound and outbound calls.
  • Fully understand all aspects of Medicare Advantage including but not limited to benefits, prior authorization, referrals, claims, enrollment, eligibility, appeals & grievances, providers networks and pharmacy services.
  • Provide accurate and complete information using the tools provided
  • Keep detailed written records of each telephone encounter during the call
  • Adhere to all call center metrics as set forth by CMS regulation and call center leadership.
  • Attempt to resolve the member’s issue completely during the first phone call.
  • Go above and beyond to provide exceptional customer service.


EDUCATION and/or EXPERIENCE:

  • 2+ years customer service experience
  • Minimum 1+ years’ experience with Medicare Advantage
  • Health Plan experience.
  • Excellent verbal and written communication skills including active listening and probing techniques.
  • Ability to multi-tasks, time manage and prioritize.
  • Ability to document information while on the phone with the member.
  • Ability to build rapport with members
  • Fluent in Spanish, Korean, Vietnamese, or Cantonese/Mandarin (verbal and written)


BENEFITS:

  • 401(k)
  • Dental Insurance
  • Health Insurance
  • Life Insurance
  • Vision Insurance
  • Paid Time Off

  • Member Services Representative

    2 months ago

    Orange Park, United States Planet Fitness Full time

    The Member Services Representative will be responsible for creating a positive member experience by providing a superior level of customer service to Planet Fitness members, prospective members and guests. Essential Duties and Responsibilities Greet Member Services, Member Service, Representative, Customer Service, Retail, Instructor

  • Member Relations Representative

    3 months ago

    Orange, United States Prospect Medical Full time

    The Member Relations Representative is responsible for acting as a liaison between members, health plans, and physicians. Individuals are required to perform at minimum 120 outbound attempts per day to Medi-Medi, Medicare, Commercial, POS and Medi-Cal members who are existing members with enrollment errors or are identified as potential terminations and...

  • Customer Service Representative

    2 months ago

    Orange, United States The Judge Group Full time

    The Judge Group is looking for Full Time Bilingual Customer Service Representatives for a great client of ours in Orange, CA!!Below is a basic overview of the position. Candidates are required to travel on-site to our clients location in Orange.The Customer Service Representative (CSR) will be the first line of contact for members and providers. The...

  • Customer Service Representative

    2 months ago

    Orange, United States Circle K Full time

    Circle K - 2504 E Chapman Ave [Retail Associate / Team Member] As a Customer Service Representative at Circle K, you'll: Provide prompt, courteous customer service and resolve customer issues on shift; Ring up all sales on cash register properly; Perform multi-function operation of fuel console, lottery machine, etc.; Inspect store facilities and equipment...

  • Member Service Representative

    2 months ago

    Orange, United States Astiva Health, Inc Full time

    Job Title: Member Service Representative (Bilingual - Vietnamese, Korean, Spanish, or Chinese) Target Compensation Range: $20.00-$25.00/hour, depending on the level of relevant qualifications and experience. About Us: Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on...

  • Customer Service Representative

    2 weeks ago

    Orange, California, United States Keith Wolfe Full time

    Customer Service RepresentativeWe are seeking a highly motivated and customer-focused individual to join our team as a Customer Service Representative. As a key member of our team, you will be responsible for establishing and maintaining strong relationships with our customers, providing exceptional service, and identifying opportunities to grow our...

  • Customer Service Representative>

    6 months ago

    Orange, United States California State Gov Full time

    California State Gov - JobID: 103705 [Customer Service Representative] As a Customer Service Representative at the State of California, you'll: Provide first response to customer service requests regarding availability of water, wastewater, and recycled water services; Perform receptionist duties, receiving telephone calls and greeting visitors in a friendly...

  • Customer Service Representative

    1 month ago

    Orange, California, United States California State Gov Full time

    Job SummaryAs a Customer Service Representative at the California State Government, you will provide exceptional service to customers regarding water, wastewater, and recycled water services. Your responsibilities will include:Responding to customer inquiries and resolving issues in a timely and professional manner.Processing utility bill payments and...

  • Customer Service Representative

    1 month ago

    Orange, California, United States Planned Parenthood Full time

    Job SummaryWe are seeking a highly skilled and customer-focused Call Center Representative to join our team at Planned Parenthood/Orange and San Bernardino Counties. As a key member of our customer service team, you will be responsible for providing exceptional service to our patients and clients, answering calls efficiently, and scheduling appointments...

  • Cashier & Front End Services Representative

    1 month ago

    Orange, Massachusetts, United States Wal-Mart Stores , Inc. Full time

    About the RoleWe are seeking a highly motivated and customer-focused Cashier & Front End Services Representative to join our team at Walmart. As a key member of our store team, you will play a vital role in delivering exceptional customer service and ensuring a seamless shopping experience for our customers.Key ResponsibilitiesProvide exceptional customer...

  • Customer Service Representative

    7 days ago

    Orange, California, United States Department of Food & Agriculture Full time

    Job Description: We are seeking a skilled Customer Service Representative to join our team. Key responsibilities include handling customer inquiries, resolving issues, and providing exceptional support. The ideal candidate will possess excellent communication and problem-solving skills.

  • Customer Service Representative

    3 weeks ago

    Orange, California, United States Alignment Healthcare Full time

    Discover a career at Alignment Healthcare, a pioneering healthcare company revolutionizing care for seniors. We're seeking a highly motivated and detail-oriented Customer Service Representative to join our Member Experience Team.As a Customer Service Representative, you'll be the face of our company, ensuring our over 1,300 employees experience exceptional...

  • Customer Service Representative

    2 months ago

    Orange Park, United States Circle K Full time

    Circle K - 1091 Blanding Blvd [Retail Associate / Team Member] As a Customer Service Representative at Circle K, you'll: Provide prompt, courteous customer service and resolve customer issues on shift; Ring up all sales on cash register properly; Perform multi-function operation of fuel console, lottery machine, etc.; Inspect store facilities and equipment...

  • Customer Service Representative

    3 weeks ago

    Port Orange, United States Circle K Full time

    Circle K - 960 Village Tr [Retail Associate / Team Member] As a Customer Service Representative at Circle K, you'll: Provide prompt, courteous customer service and resolve customer issues on shift; Ring up all sales on cash register properly; Perform multi-function operation of fuel console, lottery machine, etc.; Inspect store facilities and equipment for...

  • Customer Service Representative

    1 month ago

    Orange City, United States Circle K Full time

    Circle K - 1030 Saxon Blvd [Retail Associate / Team Member] As a Customer Service Representative at Circle K, you'll: Provide prompt, courteous customer service and resolve customer issues on shift; Ring up all sales on cash register properly; Perform multi-function operation of fuel console, lottery machine, etc.; Inspect store facilities and equipment for...

  • Customer Service Representative

    1 month ago

    Orange Park, Florida, United States MCI Careers Full time

    Job Title: Customer Service RepresentativeWe are seeking a highly motivated and customer-focused individual to join our team as a Customer Service Representative. As a key member of our customer service team, you will be responsible for providing exceptional customer service and support to our clients.Key Responsibilities:Handle customer inquiries and...

  • Customer Service Representative I

    3 months ago

    Orange, United States Alta Hospitals Full time

    This position is responsible for answering telephone calls in a prompt, courteous, professional manner and acting as a liaison between Prospect Medical/ProMed Healthcare and: members; contracted and non-contracted care providers, ancillary providers; health plans; billing companies; collection companies, to provide assistance and respond to service requests....

  • Customer Service Representative I

    1 month ago

    Orange, United States Prospect Medical Holdings Full time

    Job Description This position is responsible for answering telephone calls in a prompt, courteous, professional manner and acting as a liaison between Prospect Medical/ProMed Healthcare and: members; contracted and non-contracted care providers, ancillary providers; health plans; billing companies; collection companies, to provide assistance and respond to...

  • Customer Service Representative

    2 days ago

    Orange, United States U-Haul Full time

    Compensation Range: $16.00 to $25.00 Hourly Location: 25290 Jeronimo Rd, Lake Forest, California 92630 United States of America Are you a people person? Do you love helping others? U-Haul is in search of friendly, motivated people for the position of Customer Service Representative. As a Customer Service Representative, you will work as part of a supportive...

  • Customer Service Representative

    5 months ago

    Orange, United States U-Haul Full time

    Location: 174 Boston Post Rd, Orange, Connecticut 06477 United States of America Are you a people person? Do you love helping others? U-Haul is in search of friendly, motivated people for the position of Customer Service Representative. As a Customer Service Representative, you will work as part of a supportive team to be the face of U-Haul company's...