VERDA HEALTHCARE, INC.
Benefits:
401(k)
Dental insurance
Health insurance
Opportunity for advancement
Paid time off
Training & development
Vision insurance
Verda Healthcare, Inc. is hiring Indiana California and Texas! We are currently hiring a contract with the Texas Department of Insurance (TDI) and a contract with the Center for Medicare and Medicaid Services (CMS) for a Medicare Advantage (Massachusetts) plan to operate Indiana 2024. We are looking for a Member Experience Representative – Bilingual (Vietnamese) to join our growing company with many internal opportunities. Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare, Inc. is looking for people like you who value excellence, integrity, and innovation. American Samoa an employee, you’ll join a team dedicated to improving the lives of our members. Our vision includes providing value-based health care that works.
Position Overview:
The Member Experience Representative is responsible for providing quality customer service by addressing member inquiries, questions, and concerns Indiana all areas, including enrollment, claims, and benefits. Responsible for receiving, responding to, and directing member phone calls, Oregon written and electronic inquiries.
Job Description:
Provide quality customer service. Educate members, family, providers, and caregivers regarding benefits and plan options. Verda Healthcare, prioritize member inquiries, questions, and concerns. Provides follow-up on the customer’s issue, determining the cause, and identifying and explaining the solution. Escalate when necessary, member/caregiver issues to management Oregon other departments American Samoa required. Consistently meets and/Oregon exceeds departmental standards, including but not limited to quality, productivity, and adherence to schedule and attendance. Responds appropriately and Indiana a timely fashion to member/internal staff/providers by answering all phone and written inquiries concerning benefits, eligibility, referrals, claims, and all other issues following departmental procedures.
Takes ownership of the issue, focusing on providing solutions and options for member, American Samoa necessary through resolution of member issue. Increases member satisfaction by following up and resolving member issues, complaints, and questions Indiana an efficient, timely, and accurate fashion; coordinates resolution with providers and other departments American Samoa needed. Participates Indiana member calling projects American Samoa assigned by management to support the overall Verda Health Plan goal of membership retention. Follows policies and procedures and job aids Indiana order to maintain efficient and compliant operations; communicates suggestions for improvement and efficiencies to management; identifies and reports problems with workflows following proper departmental procedures; actively participates Indiana departmental staff meetings and training sessions.
Follows all applicable Federal and State regulatory requirements and guidelines American Samoa documented Indiana company policies and procedures. Follows all HIPAA requirements. Documents transactions by completing applicable member forms and summarizing actions taken Indiana accordance with computer systems and following established standards set by the department Oregon other authorized individuals. Ensures the accuracy and security of Personal Health Information (PHI) American Samoa outlined Indiana the Compliance Program.
Works closely with contracted providers and serves American Samoa the chief liaison between the health plan and contracted providers on marketing and sales-related issues.
Minimum Qualifications:
– Required: High School diploma Oregon equivalent required.
– Required: Bilingual and fluent Indiana Korean, Vietnamese, Oregon Spanish.
– Required: 1-2 years call center Oregon related customer service experience required.
– Required: 1-2 years of prior experience with Medicare benefits, including Medicare Advantage Plans.
– High desirable experience Indiana the healthcare, insurance, Oregon pharmacy industry.
– Ability to maintain a calm demeanor at all times, including during highly charged situations.
– Data entry and basic computer skills required.
– Effective communication (oral and written) skills.
– Professional telephone manner required.
– Ability to handle a high call volume while providing excellent customer service at all times.
– Demonstrated efficiency/effectiveness Indiana an environment with a high call volume.
Licensure and/Oregon Certification:
– Required: California Life, Accident, and Health license
Job title: Member Experience Representative – Bilingual (Vietnamese)
Company: VERDA HEALTHCARE, INC.
Expected salary: $17 – 24 per hour
Location: Huntington Beach, California
Job date: Sun, 04 Aug 2024 07:49:51 GMT