Customer Service Representative, Cantonese/Mandarin Speaking

This is a fully remote position, open to applicants in California.

📋 Description

• Respond to daily phone inquiries from members, providers, health plans, insurance brokers, collection agents, and hospitals.

• Gather information regarding members’ or providers’ issues and concerns, and offer general status updates.

• Verify authorizations, claims, eligibility, and status.

• Record calls in the company’s customer service module and NMM Queue system.

• Support supervisors and managers with additional assigned tasks.

• Conduct member outreach via mail or telephone.

• Assist members in scheduling provider appointments.

• Address walk-in member issues.

• Deliver high-quality, professional, and respectful customer service.

• Uphold strict confidentiality standards.

• Send notifications of specialist terminations to members.

• Inform Medicare members of urgent authorization approvals.

• Arrange transportation for Medicare and Medi-Cal members.

• Execute outreach project assignments.

• Manage incoming calls from members, providers, health plans, vendors, hospitals, and brokers.

• Conduct outbound follow-up calls concerning authorizations, benefits, complaints, grievances, DME, eligibility, billing, surveys, transportation, and voicemail.

• Provide concierge services for new members and IPA transfers, assist with PCP assignments, complex cases, billing and claims inquiries, and coordinate with Health Plans.

• Update call logs and offer daily or weekly status reports.

• Engage in workgroup discussions and collaborate on problem-solving with the management team.

⛳️ Requirements

• High School Diploma or GED is required.

• Proficient in Microsoft Word, Excel, and Outlook.

• Experience in customer service is essential.

• A minimum of one year of relevant experience and/or training, or a suitable combination of education and experience.

• Fluency in Cantonese or Mandarin is required.

• Previous experience in a healthcare setting is preferred.

🏝️ Benefits

• Flexible remote work arrangement.

• Monday to Friday schedule, from 8:30 AM to 5:00 PM PST.

• Commitment to Equal Employment Opportunity and Affirmative Action.

• Reasonable accommodations available for applicants with disabilities.