Bilingual Member Service Representative

Now hiring a Bilingual Member Service Representative in Alameda, CA. This MSR position requires candidates to be bilingual in Cantonese, Mandarin, or Vietnamese and has career growth potential. This would be full time / 40+ hours per week. NOT REMOTE.

If interested, please apply!

Corrin Misak - Staffing Manager II
A-Line Staffing Solutions
cmisak@alinestaffing.com or (586) 710-7958

Member Service Representative Overview:

• Shift: 8am-5pm PST M-F
• Onsite in Alameda, CA
• Pay Rate: $22-$30/hour, paid biweekly
  • Based on experience and education
  • Benefits are available to full-time employees after 90 days of employment
  • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates
• This position is a W2 contract assignment with potential to hire on permanently based upon attendance, performance, and business needs

Member Service Representative Responsibilities:

• Summary: Member Services Representatives (MSR) are the first point of contact for our members’ primary contact for both routine and complex member issues with the goal of delivering excellent customer service to our customers. The position is responsible for answering a high volume of inbound and outbound calls in a timely manner. Respond to all communications coming into Member Services in the form of email, fax, letters, chat and phone calls. Timely responses to all member communication are essential. Must effectively prioritize and flex the workload as new communication and tasks are submitted. Identify the caller’s needs, clarify information, research issues, and provide solutions and/or alternatives whenever possible. Accurately and consistently document all conversations in the electronic database. This position is a liaison between the plan, the provider network, and other community agencies. The MSR positions are flexibly staffed classification and work is expected to be performed minimally at the MRS II level. However, the initial selection will be made at the entry level MSR I. Our more advanced level position of the series is the MSR III who will be required to perform a variety of complex matters.
• Contacts: Receive, manage, and document telephone calls, emails, and other sources of contacts from members, potential members, and providers, and explain health plan benefits and plan rules. Describe the types of services offered to the Member within the managed care system. Provide clarification about issues regarding patient and physician rights and how the plan operates.
• Conflict resolution: Resolve member problems/conflicts by convening with other departmental staff as needed.
• Member communications: Create and/or mail appropriate member materials and communications as needed.
• Computer: Perform ongoing data entry which assists in the maintenance of the Member Services department database to ensure data integrity.
• Comply with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.

Member Service Representative Qualifications:

• Minimum one year of direct customer service experience, Call center experience and managed care experience a plus.
• Looking for proficiency in translating healthcare-related jargon and complex processes into simple, step-by-step instructions which members can understand and act upon.
• Bachelor’s degree or equivalent experience preferred.
• High school diploma, GED required.
• The ability to speak and understand-bilingual: Cantonese/English, Mandarin/English, Vietnamese/English, are required as designated.
  • A bilingual proficiency exam will be administered to ensure the candidate possesses the appropriate skill level to meet requirements. The successful candidate must score 90% or higher.

Additional Skills:

• Experience determining eligibility for financial assistance, insurance benefits, unemployment and/or other social services programs.
• Demonstrated knowledge expert of AAH Member Services policies and procedures
• Consistent record of meeting, maintaining, or exceeding monthly Departmental performance metrics.
• Consistent track record of documenting Service Requests accurately and clearly and monitoring open Service Requests to ensure responses and closure.
• Consistent record of high quality of work as demonstrated through call and documentation auditing, appropriate Call Disposition coding, as well as an overall acceptable monthly Member Satisfaction Survey result as assessed by Member Services Quality Specialist, MS Trainer and Member Services Supervisor.
• Demonstrated proficiency in current Customer Relationship Management (CRM) tool, phone system software Quality Management Solution, Pharmacy Benefits Management applications (PBM), Interpreter vendor scheduling software, delegate portal solutions and the Member portal.
• Demonstrated ability to effectively handle the department’s key special projects: Member Portal Request Processing, Kaiser PTE Requests, PCP retroactive and same month requests.
• Demonstrated ability to help members face-to-face in the field and/or at the offices (walk-ins). Also highly skilled at handling issues related to member bills, transportation set-up and benefit coordination with providers and pharmacy needs.

If interested, please apply to this job posting right away. I look forward to hearing from you!
Corrin Misak - Staffing Manager II
A-Line Staffing Solutions
cmisak@alinestaffing.com or (586) 710-7958