Bilingual Medicare Member Experience Specialist

Workforce Opportunity Services; Chandler (AZ); On-site; USD 30,000 - 33,000; Full time

Benefits offered by this job

401(k)

Paid time off - Vacation

Paid time off - Holiday

Paid time off - Sick Leave

Health insurance - Medical

Health insurance - Dental

Health insurance - Vision

Life insurance

Job summary

Workforce Opportunity Services (WOS) is hiring a Member Experience Representative to support Medicare Advantage members in Chandler, AZ. This on-site role blends phone, email, and in-person interactions to explain benefits, enrollments, claims, and referrals.

Ideal candidates have 1–2 years in healthcare or insurance customer service, bilingual English-Vietnamese ability, and solid data-entry skills. Expect adherence to HIPAA, quality targets, and occasional travel or cross-department

Qualifications

• Bilingual: Fluent in English and Vietnamese.
• High school diploma or equivalent.
• 1 to 2 years of call center or related customer service experience.
• 1 to 2 years of experience with Medicare benefits, including Medicare Advantage plans.
• Experience in the healthcare, insurance or pharmacy industry is highly desirable.
• Ability to stay calm in charged situations.
• Data entry and general computer skills.
• Effective written and oral communication and a professional, pleasant telephone manner.
• Ability to handle high call volume while giving excellent customer service, with a record of efficiency in a high-volume environment.

Responsibilities

• Provide excellent customer service.
• Accurately explain benefits and plan options in person, by email or by phone, including to members, family members, providers and caregivers.
• Follow up with members by clarifying the issue, determining the cause, identifying how to resolve it and explaining the solution.
• Escalate member issues to management or other departments as required.
• Meet or exceed departmental standards for quality, productivity, and schedule and attendance adherence.
• Respond in a timely way to members, internal staff and providers through phone calls, omnichannel interactions and in-person discussions about benefits, eligibility, referrals, claims and other issues, following policies, procedures and job aids.
• Take ownership of an issue and focus on solutions and options for the member through resolution.
• Increase member satisfaction by following up on and resolving issues, complaints and questions efficiently and accurately, coordinating with providers and other departments as needed.
• Take part in member calling projects assigned by management, such as membership retention.
• Follow policies, procedures and job aids to keep operations efficient and compliant. Suggest improvements and report workflow problems through the proper channels. Take part in staff meetings and training.
• Follow all applicable federal and state regulatory requirements and all HIPAA requirements.
• Document interactions by completing member forms and summarizing actions taken in the computer system, following department standards.
• Work with other departments as needed.
• Meet attendance and schedule adherence expectations and individual performance goals such as call quality and attendance.
• Other duties as assigned.

Skills

Bilingual English-Vietnamese

Call center experience

Data entry

Effective communication

High-volume environment

Calm under pressure

Education

High school diploma or equivalent

Job description

Workforce Opportunity Services (WOS) is hiring a Member Experience Representative to support Medicare Advantage members in Chandler, AZ. This on-site role blends phone, email, and in-person interactions to explain benefits, enrollments, claims, and referrals.

Ideal candidates have 1–2 years in healthcare or insurance customer service, bilingual English-Vietnamese ability, and solid data-entry skills. Expect adherence to HIPAA, quality targets, and occasional travel or cross-department