Bilingual Member Services Specialist

2 weeks ago


Huntington Beach, California, United States VERDA HEALTHCARE, INC. Full time
Position Overview

Verda Healthcare, Inc. is seeking a dedicated Bilingual Member Services Specialist to enhance our customer support operations. This role is pivotal in delivering exceptional service to our members, ensuring their inquiries and concerns are addressed with utmost professionalism.

Key Responsibilities
  • Customer Engagement: Provide outstanding service by addressing member inquiries related to enrollment, claims, benefits, and medical care authorizations.
  • Communication: Clearly explain benefits and plan options through various channels, including in-person, email, and phone interactions.
  • Issue Resolution: Follow up with members to clarify issues, determine causes, and provide effective solutions, escalating matters to management when necessary.
  • Performance Standards: Consistently meet departmental benchmarks for quality, productivity, and attendance.
  • Member Satisfaction: Enhance member satisfaction by efficiently resolving complaints and coordinating with other departments as needed.
  • Project Participation: Engage in member outreach initiatives to support retention goals.
  • Compliance: Adhere to all federal and state regulations, ensuring compliance with HIPAA and company policies.
  • Documentation: Accurately document member interactions and actions taken in the appropriate systems.
  • Collaboration: Work closely with other departments to facilitate effective communication and service delivery.
  • Continuous Improvement: Actively participate in training sessions and provide feedback for process enhancements.
Qualifications
  • High School diploma or equivalent.
  • Bilingual proficiency in English and Vietnamese.
  • 1-2 years of experience in a call center or customer service role.
  • Familiarity with Medicare benefits, particularly Medicare Advantage Plans, is preferred.
  • Strong communication skills, both oral and written, with a professional demeanor.
  • Ability to manage high call volumes while maintaining excellent service standards.
Licensure

Must possess a valid CA Life, Accident, and Health license.

Physical Requirements

Regularly required to sit or walk at a workstation. Must be able to lift and/or move up to 25-50 pounds occasionally.

Other responsibilities may be assigned to support the ongoing success of Verda Healthcare.



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