Member Services Representative -Healthcare
12 days ago
Long Beach
Job Description Johnson Service Group is seeking Member Services Representatives. This is a remote position. Bilingual Required: Mandarin, Cantonese, Korean, Vietnamese, and Spanish. Must live in Texas, New Mexico, Nevada, Arizona or CA. Work schedule: Training: 7 weeks M-F, 8:00 am-4:00 pm Work hours available: 6 am-8 pm, PST, weekend rotation, and some holidays required. Pay rate: $21/hr. Bilingual Pay rate: $20/hr. Non-Bilingual Job Summary: Serves members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals, claims, and any other aspects of plan benefits and services. Ensures member satisfaction by providing superior customer service and willingness to help at all times while maintaining a professional demeanor. Responsibilities: • Provides 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, but not limited to: 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 the resolution of member issues., • 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 goal of membership retention., • Follows all appropriate Federal and State regulatory requirements and guidelines applicable to company operations, as documented I company policies and procedures. Follows all HIPAA requirements., • Documents transactions by completing applicable member forms and summarizing actions taken in the appropriate computer system and following standards set by the department or by other authorized individuals., • Temporarily responds to routine member questions and concerns on specific medical group call queues as part of skill development., • Contributes to team effort by accomplishing related results as needed., • Bilingual Requirement: Korean, Mandarin, Cantonese, Vietnamese, Spanish, • 1-2 years of call center or related customer service experience is required., • 1-2 years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred., • Experience in the healthcare, insurance, or pharmacy industry is highly desirable., • Ability to maintain a calm demeanor at all times, including during highly charged situations., • Data entry and general computer skills (word processing, e-mail) required., • Effective communication (oral and written) skills. Professional/pleasant telephone manner required., • Ability to handle large call volume, while providing excellent customer service at all times required. Johnson Service Group, Inc. (JSG) is a North American leader in the staffing and consulting services industry, with 40 years of experience investing in people and companies. We are always looking for great people to join our team—we want to see your success here at JSG! We can be found locally in more than 30 offices throughout the United States and Canada. JSG continues to work diligently to offer our clients and candidates world-class service and diversified offerings to fit their evolving needs. We offer medical, dental, vision, life insurance options, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.Our people and culture make JSG a great place to work. JSG’s mission is to empower people, help our clients reach their goals, and hire motivated individuals.\r\n\r\nJohnson Service Group, Inc. (JSG) is a North American leader in the staffing and consulting services industry, with 40 years of experience investing in people and companies. We are always looking for great people to join our team—we want to see your success here at JSG! We can be found locally in more than 30 offices throughout the United States and Canada. JSG continues to work diligently to offer our clients and candidates world-class service and diversified offerings to fit their evolving needs.\r\n\r\nWe offer medical, dental, vision, life insurance options, 401(k), weekly pay, and more.\r\n\r\nJohnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.