Bilingual Medicare Member Advocate - Frontline Support

Community Hospital of the Monterey Peninsula; Monterey (CA); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Competitive benefit package

Job summary

Aspire Health Plan in Monterey, CA is seeking a Customer Service Representative I to be the friendly front line for members, providers, and clients. You will handle inbound calls, emails, and occasional in-person inquiries about eligibility, benefits, and claims, delivering compassionate and accurate responses.

Ideal candidates have an associates degree or equivalent experience, 1–3 years in customer service, and bilingual Spanish/English is a plus.

Qualifications

• Associates degree, or applicable professional experience, required.
• Minimum 1 to 3 years experience in a customer service, hospitality, or call center.

Responsibilities

• Serve as a primary point of contact for members, providers, and clients via phone, email, and occasional in‑person interactions
• Assist with questions related to eligibility, benefits, claims status, prior authorization requirements, and appeals
• Provide accurate, timely, and compassionate responses to all customer inquiries
• Proactively educate members and providers based on their specific needs and inquiries, helping them better understand available benefits and next steps
• Thoroughly document all communications and actions in the appropriate system of record
• Research issues and work diligently to bring each inquiry to resolution within established timeframes
• Coordinate member appeals and grievances in collaboration with appropriate internal teams
• Provide support and coverage for interdepartmental staff as needed to ensure continuity of service
• Perform other duties and responsibilities as assigned

Skills

Communication skills

Active listening

Problem solving

Customer service

Education

Associate degree

Job description

Aspire Health Plan in Monterey, CA is seeking a Customer Service Representative I to be the friendly front line for members, providers, and clients. You will handle inbound calls, emails, and occasional in-person inquiries about eligibility, benefits, and claims, delivering compassionate and accurate responses.

Ideal candidates have an associates degree or equivalent experience, 1–3 years in customer service, and bilingual Spanish/English is a plus.