What are the responsibilities and job description for the Member Experience Representative – Bilingual (Spanish or Vietnamese) position at Verda Healthcare?
Description
Member Experience Representative – Bilingual (Spanish or Vietnamese)
Job Description
Minimum Qualifications
Job Type: Full-time (Full Time Weekend rotation. Schedule to be determined)
Onsite: 100% onsite
Benefits
Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.
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.
Minimum Qualifications
- Required: High School diploma or equivalent required.
- Bilingual and fluent in English AND one of the following: Vietnamese or Spanish
- 1-2 years call center or related customer service experience required.
- 1-2 years of prior experience with Medicare
- re benefits, including Medicare Advantage Plans
- Experience in the healthcare, insurance, or pharmacy industry is highly desirable.
- Ability to maintain calm demeanor, including during charged situations.
- Data entry and general computer skills required.
- Effective communication (oral and written) skills. Professional /pleasant telephone manner required.
- Professional /pleasant telephone manner required.
- Ability to handle large call volume, while always providing excellent customer service
- Demonstrated efficiency/effectiveness is an environment with a high call volume.
- Integrity and Trust
- Customer Focus
- Functional/Technical Skills
- Written/Oral Communications
- Critical/Analytical Thinker
Job Type: Full-time (Full Time Weekend rotation. Schedule to be determined)
Onsite: 100% onsite
Benefits
- 401(k)
- Dental Insurance
- Health insurance
- Life insurance
- Paid time off.
- Vision insurance
- Reliably commute or planning to relocate before starting work (Required)
Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.
- Other duties may be assigned in support of departmental goals.