Member Services Representative

Astrana Health; California (MO); On-site; USD 52,000 - 58,000; Full time

Job summary

A growing health services provider is seeking a Member Services Representative in California. This role involves responding to inquiries from members and providers, requiring strong customer service skills and bilingual proficiency in English and Cantonese. Candidates should have at least a high school diploma and prior experience in healthcare settings. Competitive salary range of $52,000 - $58,000 offered.

Qualifications

• 1+ year of customer service experience in a healthcare setting preferred.
• Strong communication and problem-solving skills required.
• Bilingual proficiency in English and Cantonese is mandatory.

Responsibilities

• Respond to inbound calls from members and providers.
• Provide information and resolve inquiries related to claims and benefits.
• Document all customer interactions in the service system.

Skills

Customer service experience

Communication skills

Problem-solving skills

Bilingual in English and Cantonese

Education

High School Diploma or GED

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Join to apply for the Member Services Representative (San Francisco, San Mateo) - Cantonese Bilingual role at Astrana Health

Overview

Astrana Health is looking for a Cantonese speaking Member Services Representative to join our growing team. In this role, you’ll be the first point of contact for members, providers, health plans, and other partners—helping resolve inquiries with empathy, professionalism, and accuracy.

What You’ll Do

• Respond to inbound calls from members, providers, health plans, brokers, and hospitals
• Provide information and resolve inquiries related to authorizations, claims, eligibility, and benefits
• Document all interactions in the company’s customer service system
• Assist with appointment scheduling, member outreach, and provider coordination
• Support walk-in members and help resolve concerns in person
• Arrange transportation for Medicare/Medi-Cal members when needed
• Handle special projects such as outreach campaigns, member surveys, and concierge support for new members
• Communicate professionally and maintain confidentiality at all times

Key Responsibilities

• Inbound Support
• Verify eligibility, authorizations, claims, and demographic updates
• Address member/provider complaints and grievances
• Assist with pharmacy, lab, urgent care, and provider network inquiries
• Support Medicare-specific needs such as AOR requests, AWV scheduling, and urgent notifications

• Outbound Support
• Conduct follow-up calls for authorizations, benefits, complaints, and billing resolution
• Provide translation support (Spanish/Chinese) for DME and appointment confirmations
• Assist with outreach projects, surveys, and case management follow-ups

• Concierge Services
• Welcome and support new members, including PCP assignment and network guidance
• Coordinate with providers, health plans, and internal teams on complex cases
• Facilitate billing/claims support and problem-solving for escalated issues

Qualifications

• High School Diploma or GED
• 1+ year of customer service experience (healthcare setting preferred)
• Proficiency with Microsoft Word, Excel, and Outlook
• Strong communication and problem-solving skills
• Bilingual in English and Cantonese

Environmental Job Requirements and Working Conditions

• This role follows an onsite work structure where the expectation is to work in-office on a weekly basis. The position is located in San Francisco, Daly City, and Burlingame.
• The total compensation pay range for this role is $52,000 - $58,000. This salary range represents national target range for this role.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [e-mail] to request an accommodation.

Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.