Medicare Advantage Member Support Specialist

Astiva Health; California; On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

401(k)

Dental Insurance

Health Insurance

Life Insurance

Vision Insurance

Paid Time Off

Free catered lunches

Job summary

Astiva Health in Orange, CA seeks a Member Service Specialist to handle inbound/outbound calls from members and providers regarding Medicare Advantage benefits, enrollment, claims, and appeals. You will resolve issues, explain plan details, and maintain professional customer service with a focus on accuracy and efficiency.

Requirements include 2+ years in customer service, 1+ year with Medicare Advantage, health plan experience, and fluency in Vietnamese, both spoken and written.

Qualifications

• 2+ years customer service experience.
• Minimum 1+ years’ experience with Medicare Advantage.
• Health Plan experience.
• Excellent verbal and written communication skills including active listening and probing techniques.
• Ability to multi-task, time manage and prioritize.
• Ability to document information while on the phone with the member.
• Ability to build rapport with members.
• Fluent in Vietnamese (verbal and written).

Responsibilities

• Handle inbound and outbound phone calls, emails and other necessary communications with members and providers.
• Clearly identify and act on customer needs to achieve satisfaction.
• Explain Medicare Advantage plan details, procedures, benefits and information.
• Understand all aspects of Medicare Advantage including benefits, prior authorization, referrals, claims, enrollment, eligibility, appeals and grievances.
• Provide accurate information using the tools provided.
• Keep detailed written records of each telephone encounter.
• Adhere to call center metrics set by CMS and leadership.
• Attempt to resolve issues completely during the first call.

Skills

Customer service

Medicare Advantage knowledge

Phone support

Verbal & written communication

Active listening

Multitasking

Rapport building

Vietnamese language

Job description

Astiva Health in Orange, CA seeks a Member Service Specialist to handle inbound/outbound calls from members and providers regarding Medicare Advantage benefits, enrollment, claims, and appeals. You will resolve issues, explain plan details, and maintain professional customer service with a focus on accuracy and efficiency.

Requirements include 2+ years in customer service, 1+ year with Medicare Advantage, health plan experience, and fluency in Vietnamese, both spoken and written.