HYBRID CSR (Bilingual Mandarin)

Medix; New York (NY); Híbrido; USD 42.000 - 66.000; Jornada completa

Descripción de la vacante

Medix is seeking a Bilingual Member Services Representative (Mandarin/English) to support members navigating benefits within a healthcare plan environment. This full-time role offers remote/hybrid work with a focus on high-quality member service and problem resolution.

You will respond to calls, assist with plan coverage, schedule appointments, and educate members on benefits, including Medicaid/Medicare processes using interpretation tools as needed.

Formación

• High School Diploma or equivalent required.
• Minimum of 3 years of healthcare experience required.
• Fluent in Mandarin and English (spoken and written).
• Experience working for a health plan or managed care organization preferred.
• Proficient with Microsoft Office Suite and general computer applications.

Responsabilidades

• Answer calls from members and providers about benefits, services, and plan coverage.
• Help members access covered and non-covered services per their plan of care.
• Conduct post-enrollment orientations for members and authorized reps.
• Educate members on plan benefits, authorization processes, and provider access.
• Assist members in scheduling appointments with PCPs and providers.
• Respond to inquiries, complaints, grievances, and appeals; document and resolve issues.

Conocimientos

Mandarin & English

Customer service

Healthcare experience

Communication skills

MS Office

Educación

High School Diploma or equivalent

Herramientas

Microsoft Office Suite

Descripción del empleo

Job Description

Job Description

Member Services Representative (Bilingual Mandarin)

Location: Remote/Hybrid (as applicable)
Schedule: Full-Time
Education Required: High School Diploma
Experience: Minimum 3 years of healthcare experience

We are seeking a Bilingual Member Services Representative (Mandarin/English) to join our growing healthcare team. This role is ideal for someone with a strong customer service background in a health plan or managed care environment who is passionate about helping members navigate their healthcare benefits and access the services they need. The ideal candidate is compassionate, organized, and able to communicate effectively with diverse populations.

Responsibilities

• Answer incoming calls from members and providers, addressing questions regarding benefits, services, and plan coverage.
• Assist members in accessing covered and non-covered services in accordance with their individualized plan of care.
• Conduct post-enrollment orientations for members, family members, and authorized representatives.
• Educate members on plan benefits, service authorization processes, provider access, and healthcare resources.
• Assist members in scheduling appointments with primary care physicians and participating providers.
• Respond to member inquiries, complaints, grievances, and appeals while documenting and resolving concerns whenever possible.
• Educate members on their rights, including grievance procedures, fair hearings, and external review options.
• Clarify information contained in member handbooks and online plan resources.
• Coordinate communication between members, providers, subcontractors, and the Interdisciplinary Care Team.
• Conduct medication reminder calls as directed by the care management team.
• Assist members with selecting participating healthcare providers.
• Support the Interdisciplinary Care Team by completing non-clinical assessments and entering service authorizations.
• Utilize interpretation services and accessibility tools (TTY, Braille, large print, adaptive equipment, etc.) to effectively communicate with members with special needs.
• Assist members with Medicaid renewal and eligibility processes.
• Participate in special projects and departmental initiatives as needed.

Qualifications

• High School Diploma or equivalent required.
• Minimum of 3 years of healthcare experience required.
• Experience working for a health plan or managed care organization strongly preferred.
• Fluent in both Mandarin and English (spoken and written) is required.
• Strong knowledge of Medicaid and Medicare programs.
• Proficiency with Microsoft Office Suite and general computer applications.
• Excellent verbal and written communication skills.
• Strong customer service, problem-solving, and organizational abilities.
• Ability to handle sensitive conversations with professionalism, empathy, and cultural awareness.
• Experience working with diverse populations and individuals with special needs is highly preferred.

Ideal Candidate

We're looking for someone who:

• Has a healthcare or health plan background.
• Is passionate about helping members understand and access their healthcare benefits.
• Thrives in a fast-paced, service-oriented environment.
• Demonstrates professionalism, integrity, and exceptional communication skills.
• Is highly organized and able to manage multiple priorities while providing outstanding member support.

If you're a compassionate healthcare professional who is bilingual in Mandarin and English and enjoys making a positive impact on members' healthcare experiences, we'd love to hear from you!

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business o