Clever Care Health Plan Inc. Is Hiring A Customer Service Representative Bilingual

Join Clever Care, one of Southern California's fastest-growing Medicare Advantage plans, and make a meaningful impact in transforming healthcare while enjoying a vibrant, inclusive work environment! 🚀

Who Are We? 🤝

Clever Care was founded to address the unique needs of the diverse communities we serve. Our innovative benefit plans blend Western medicine with holistic Eastern practices, providing benefits that resonate with our members' cultures and values.

Why Join Us? 🌟

• Be part of a mission-driven organization that prioritizes accessible healthcare for underserved communities.
• Enjoy the opportunity to make a real difference in people's lives and shape the future of healthcare.
• Join a fast-moving, game-changing organization that celebrates diversity and innovation.

Job Summary 📝

Member Advocates serve as the primary point of contact at Clever Care, engaging with members, prospective members, providers, brokers, and vendors. They address inquiries related to benefits, eligibility, referrals, claims, and other plan services, ensuring a high level of member satisfaction through superior customer service and professionalism.

Core Responsibilities & Functions 🎯

• Educate members, families, providers, and caregivers about benefits and plan options.
• Clearly explain benefits and options via in-person, email, fax, or phone communications.
• Follow up with members to clarify issues, identify causes, and communicate solutions; escalate issues when necessary.
• Participate in member calling projects to support membership retention goals.
• Adhere to policies, procedures, and job aids to ensure efficient and compliant operations.
• Report workflow issues and contribute suggestions for process improvements.
• Comply with all federal and state regulatory requirements, including HIPAA guidelines.
• Document transactions accurately in the computer system and complete applicable forms.
• Work in an environment open to continuous coaching and feedback.
• Perform other duties as assigned.

Qualifications ✅

Education & Experience

• High School Diploma or equivalent required.
• Bachelor’s Degree or comparable work experience preferred.
• At least two (2) years of customer service experience, preferably in healthcare management or call centers.

Skills & Competencies 🛠️

• Knowledge of Centers for Medicare and Medicaid Services (CMS) regulations.
• Bilingual abilities in Cantonese, Mandarin, Vietnamese, Korean, Spanish, Thai, Khmer, or Japanese may be required.
• Exceptional verbal and written communication skills.
• Strong active listening skills.
• Team-oriented with the ability to collaborate effectively.
• Quick learner with excellent multitasking capabilities (listening, talking, typing).
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Typing speed of 40 WPM, with 60 WPM preferred.

Additional Requirements ⚙️

• Willingness to work some weekends from October through March.

Compensation 💰

Wage range: $20 - $23 per hour

Physical & Working Environment 🏢

Physical requirements to perform essential job functions include:

• Ability to travel as needed.
• Operate a keyboard, mouse, and phone; perform repetitive motions.
• Sit for extended periods; stand, reach, bend, and lift up to 15 lbs.
• Effective communication to convey detailed instructions clearly and quickly.

Work is primarily conducted in an office or remote setting with frequent staff and public contact. Some irregular hours may be required based on business needs.

Equal Opportunity Employment 🌈

Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. We consider applicants without regard to race, color, national origin, religion, age, sex (including pregnancy and childbirth), sexual orientation, gender identity, disability, veteran status, or any other protected status. A background check is required.

Note: Salary ranges are based on California wages and may vary depending on the candidate's state residency.

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