Outbound Medicare Member Services Specialist

Astiva Health; Orange (CA); On-site; USD 28,000 - 34,000; Full time

Benefits offered by this job

401(k)

Dental Insurance

Health Insurance

Life Insurance

Vision Insurance

Paid Time Off

Job summary

Astiva Health, located in Orange, CA, is seeking a dedicated Member Service Specialist to handle Medicare Advantage inquiries from members and providers. You will deliver high-quality customer service, explain benefits, and assist with enrollment, claims, and authorizations while meeting performance KPIs.

The role requires strong communication, data-entry skills, and flexibility to work evenings/weekends. Bilingual candidates are strongly preferred to serve a diverse community.

Qualifications

• Excellent verbal communication and active listening.
• Strong persuasion and objection-handling abilities.
• Resilience and ability to handle rejection positively.
• Basic computer skills, accurate typing (CRM navigation, data entry).
• Clear, professional phone voice with good diction and tone.
• Ability to work flexible schedules including evenings and weekends if needed.
• Ability to build rapport with members.
• Bilingual in Vietnamese, Spanish, Korean, or Chinese (Cantonese/Mandarin) required.

Responsibilities

• Answer telephonic inquiries from current and potential members and providers.
• Explain Medicare Advantage benefits, eligibility, enrollment, claims, referrals, prior authorizations, appeals & grievances.
• Make outbound calls as per campaign targets (80–150+ daily).
• Collect data using scripts and adapt to responses.
• Meet or exceed KPIs like talk time and conversion rate.
• Follow compliance guidelines and participate in training.
• Maintain attendance and provide exceptional customer service.

Skills

Verbal communication

Active listening

Persuasion

Resilience

Rapport building

Flexible scheduling

Tools

CRM navigation

Data entry

Job description

Astiva Health, located in Orange, CA, is seeking a dedicated Member Service Specialist to handle Medicare Advantage inquiries from members and providers. You will deliver high-quality customer service, explain benefits, and assist with enrollment, claims, and authorizations while meeting performance KPIs.

The role requires strong communication, data-entry skills, and flexibility to work evenings/weekends. Bilingual candidates are strongly preferred to serve a diverse community.