Medix Is Hiring A Hybrid Member Service Representative Bilingual Mandarin

Join our team as a Member Services Representative (Healthcare) and play a vital role in delivering exceptional support and service to members and providers. This position ensures a smooth healthcare journey for our members through compassionate communication and effective assistance.

Position Overview

The Member Services Representative acts as the primary point of contact for members and providers, focusing on delivering outstanding customer service. Key responsibilities include helping members navigate their benefits, resolve concerns, and access healthcare services seamlessly.

Key Responsibilities

• 📞 Answer calls from members and providers, addressing questions related to benefits, services, and care plans
• 🗓️ Assist members in accessing covered and non-covered services, including scheduling appointments with primary care physicians and specialists
• 🎓 Conduct post-enrollment orientations for members, families, and representatives, explaining plan benefits, policies, and procedures
• 💡 Educate members on how to access services, use their benefits, and navigate the healthcare system
• 📝 Respond to and document member inquiries, complaints, and grievances; resolve issues promptly
• ⚖️ Inform members of their rights, including grievance and appeals processes, fair hearings, and external review options
• 🔍 Clarify information from member materials, including handbooks and online resources
• 🤝 Facilitate communication between members, providers, subcontractors, and the Interdisciplinary Care Team
• 📱 Provide medication reminder calls as directed by the care team
• 🖥️ Assist with non-clinical assessments and data entry of service authorizations
• 🔄 Support members with Medicaid renewal and eligibility-related processes
• 🌐 Communicate effectively with individuals with diverse needs using interpretation services and adaptive tools (e.g., TTY, large print, braille)
• 🚀 Participate in special projects and support departmental initiatives

Qualifications

Education:

• 🎓 High School Diploma or equivalent required

Experience:

• 🕒 Minimum of 3 years of experience in a healthcare or call center environment
• 💙 Experience supporting Medicaid and/or Medicare populations preferred
• 💻 Strong computer skills, including proficiency in Microsoft Office Suite
• 🗣️ Bilingual skills (preferred but not required)

Core Competencies

• 🌟 Customer Service Excellence: Demonstrates empathetic, member-focused support
• 🏥 Healthcare Knowledge: Understanding of healthcare services, insurance, and managed care
• 🗣️ Communication Skills: Clear, professional verbal and written communication
• 🔧 Problem Solving: Effectively assesses issues and identifies solutions
• 📂 Organization & Multitasking: Manages multiple priorities efficiently
• 🌎 Cultural Competency: Works effectively with diverse populations and sensitive situations
• 🤝 Team Collaboration: Collaborates effectively with interdisciplinary teams and partners
• 🔒 Integrity & Accountability: Maintains confidentiality and adheres to compliance standards