Member Experience Representative, Bilingual (Mandarin or Cantonese)

Workforce Opportunity Services; Huntington Beach (CA); On-site; USD 33,000 - 36,000; Full time

Benefits offered by this job

401(k)

Paid time off

Health insurance

Dental

Vision

Life insurance

Job summary

Workforce Opportunity Services in Huntington Beach, CA is seeking a Member Experience Representative to support Medicare Advantage members. The role blends phone, email, and in-person interactions to explain benefits, answer questions, and guide members and caregivers through enrollment and claims processes.

The ideal candidate is bilingual (English and Vietnamese) with 1–2 years of call center or healthcare benefits experience, strong communication skills, and the ability to manage high call

Qualifications

• High school diploma or equivalent.
• 1–2 years of call center or related customer service experience.
• 1–2 years of Medicare benefits experience, including Medicare Advantage plans.
• Healthcare/insurance/pharmacy industry experience desirable.
• Ability to stay calm in charged situations.
• Data entry and general computer skills.
• Effective written and oral communication with a professional telephone manner.
• Ability to handle high call volume while delivering excellent service.

Responsibilities

• Provide excellent customer service.
• Explain benefits and plan options in person, by email or by phone to members, family, providers and caregivers.
• Follow up with members to clarify issues, determine causes, resolve issues and explain solutions.
• Escalate issues to management or other departments as needed.
• Meet or exceed quality, productivity and attendance standards.
• Respond promptly to members and providers via phone, email, and in-person interactions per policies and job aids.
• Take ownership of issues and work toward solutions.
• Increase member satisfaction by resolving issues and coordinating with providers.
• Participate in member calling projects such as retention efforts.
• Adhere to policies, procedures and job aids; report workflow improvements.
• Follow HIPAA and all regulatory requirements.
• Document interactions by completing member forms and summarizing actions.
• Collaborate with other departments as needed.
• Meet attendance and performance goals.
• Perform other duties as assigned.

Skills

Bilingual English-Vietnamese

Education

High school diploma or equivalent

Tools

CRM software

Job description

Overview

Workforce Opportunity Services (WOS)is a leading 501(c)(3) nonprofit dedicated to developing the skills of high-potential individuals who may not have access to career opportunities. Through strategic partnerships, WOS connects motivated talent with organizations seeking to expand their workforce with skilled professionals.

Utilizing a scientifically based model derived from research conducted at Columbia University, we recruit, educate, train, and place high-potential talent with leading organizations around the world.

Overall Position Description:

• This is Member Experience Representative positions in a contact center supporting members who are senior citizens covered by Medicare Advantage plan. In some cases, the Member Experience Representative also interacts with physicians and providers, insurance brokers and members' caregivers. The work mixes phone calls, email and other written channels, and in-person conversations, so there is more variety than a typical contact center job. Member Experience Representatives balance those interactions with documenting and servicing members in the company's software systems, which takes strong multitasking.

• The Member Experience Representative provides quality customer service by addressing member inquiries, questions and concerns about enrollment, claims, benefit interpretation, and referrals and authorizations for medical care. The Member Experience Representative receives, answers and directs member calls and written questions, and educates members, family, providers and caregivers about benefits and plan options. The role also has some in-person interactions with members.

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.

Qualifications

Candidate Profile / 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.

Physical demands

• Regularly sit or walk at a workstation in an office or cubicle setting
• Occasionally lift or move 25 to 50 pounds.

Additional Information

Duration/Schedule:

• Full-Time (40 hours/Week)
  • Monday-Friday
  • 9:00AM-6:00PM

Salary:

• $24.00 - 26.00/Hour (Plus Benefits)

Location:

• Huntington Beach, CA
  • On-Site-Must be able to commute reliably
  • Occasional travel for meetings and training

Benefits

• 401(k)
• Paid time off
  • Vacation
  • Holiday
  • Sick Leave
• Health insurance
  • Medical
  • Dental
  • Vision
• Life insurance

About Us

Our vision is to empower early-career professionals to achieve long-lasting professional success and financial independence while supporting companies in building workplaces that reflect and engage with the communities they serve.We are in the business of creating dynamic partnerships that transform lives.

Pay Range

USD $24.00 - USD $26.00 /Hr.