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Bilingual Vietnamese Member Support Specialist

2 months ago


Houston, Texas, United States VERDA HEALTHCARE, INC. Full time
Job Overview

Verda Healthcare, Inc. is engaged in a partnership with the Center of Medicaid and Medicare Services (CMS) and the Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan. We are seeking a Bilingual Vietnamese Member Experience Representative to enhance our dedicated team, offering numerous internal growth opportunities.

Are you prepared to contribute to a transformative healthcare organization? At Verda Healthcare, Inc., we are in search of individuals who embody excellence, integrity, compassion, and innovation. As a member of our team, you will play a vital role in enriching the lives of our Medicare members, with a vision centered on value-based healthcare.

Key Responsibilities
  • Deliver exceptional customer service by educating members, families, providers, and caregivers about benefits and plan options.
  • Provide clear explanations of benefits and plan options through various communication channels.
  • Follow up with members to clarify issues, identify causes, and communicate solutions effectively.
  • Escalate relevant member concerns to management or other departments as necessary.
  • Consistently meet or exceed departmental standards in quality, productivity, and attendance.
  • Respond promptly to inquiries from members and internal staff regarding benefits, eligibility, referrals, claims, and other issues.
  • Take ownership of member issues, focusing on providing effective solutions.
  • Enhance member satisfaction by resolving complaints and inquiries efficiently.
  • Participate in member outreach initiatives to support membership retention goals.
  • Adhere to policies and procedures to ensure compliant operations, and actively contribute suggestions for improvement.
  • Maintain compliance with all Federal and State regulations relevant to Verda Health Plan operations.
  • Document all transactions accurately in the designated systems.
  • Collaborate proactively with other departments as needed.
  • Demonstrate accountability by meeting attendance and schedule adherence expectations.
  • Achieve individual performance metrics related to call quality and overall objectives.
Minimum Qualifications

Required:

  • High School diploma or equivalent.
  • Bilingual proficiency in English and Vietnamese.
  • 1-2 years of experience in a call center or related customer service role.
  • Familiarity with Medicare benefits, particularly Medicare Advantage Plans.
  • Experience in the healthcare, insurance, or pharmacy sectors is preferred.
  • Ability to maintain composure in challenging situations.
  • Proficient in data entry and general computer skills.
  • Strong oral and written communication skills, with a professional telephone demeanor.
  • Capacity to manage a high volume of calls while delivering excellent customer service.
  • Demonstrated effectiveness in a fast-paced environment.
Professional Competencies
  • Integrity and Trust
  • Customer Focus
  • Functional/Technical Skills
  • Written/Oral Communication
  • Critical/Analytical Thinking

Verda Healthcare, Inc. is committed to the growth and well-being of its employees. We offer a comprehensive benefits package, including 401(k), health insurance, dental and vision coverage, life insurance, and paid time off.

Physical Demands

Regularly required to sit or walk at a workstation in an office environment. Occasional lifting of up to 25-50 pounds may be necessary.

Other duties may be assigned to support departmental objectives.