What are the responsibilities and job description for the Member Experience Representative - Bilingual (Spanish or Vietnamese) position at Verda Healthcare Inc?
Job Description
Job Description
Description :
Member Experience Representative – Bilingual (Spanish or Vietnamese)
Job Description
- Provide quality customer service. Educates members, family, providers and caregivers regarding benefits and plan options.
- Accurately explains benefits and plan options in person, via email or telephonically.
- Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution. Escalates appropriate member issues to management or other departments as required.
- Consistently meets and / or exceeds the departmental standards, including quality, productivity, and adherence to schedule and attendance.
- Responds appropriately and in a timely fashion to member / internal staff / providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues following departmental policies and procedures and job aids. Takes ownership of the issue, focusing on providing solutions and options for members, as necessary through resolution of member issue.
- Increases member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion; coordinates resolution with providers and other departments as needed.
- Participates in member calling projects as assigned by management to support the overall Verda Health Plan goal of membership retention.
- Follows policies and procedures and job aids to maintain efficient and complaint operations; communicates suggestions for improvement and efficiencies to management; identifies and reports problems with workflows following proper departmental procedures; actively participates in departmental staff meetings and training sessions.
- Follows all appropriate Federal and State regulatory requirements and guidelines applicable to Verda Health Plan operations, as documented in company policies and procedures. Follows all HIPAA requirements.
- Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals.
- Proactively engages and collaborates with other departments as required.
- Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations.
- Achieves individual performance goals established for this position in call quality, attendance, schedule adherence, and individual performance goals relating to call center objectives.
Requirements :
Minimum Qualifications
Professional Competencies
Verda cares deeply about the future, growth, and well-being of its employees. Join our team today!
Job Type : Full-time (Full Time Weekend rotation. Schedule to be determined)
Onsite : 100% onsite
Benefits :Ability to commute / relocate :
PHYSICAL DEMANDS
Regularly sit / walk at a workstation in an office or cubicle setting. Must occasionally lift and / or move up to 25-50 pounds.