Medix Is Hiring A Hybrid Member Service Representative Bilingual Mandarin

Join our team as a Member Services Representative (Healthcare) and become the vital link connecting members and providers with exceptional support and service! 🚑💼

Position Overview

The Member Services Representative acts as the primary point of contact for members and healthcare providers, delivering outstanding customer service. The role involves assisting members with understanding and navigating their healthcare benefits, accessing services, resolving concerns, and ensuring a smooth and seamless member experience. 😊

Key Responsibilities

• 📞 Answer incoming 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 obtain services, utilize benefits, and navigate the healthcare system
• 🔍 Respond to and document member inquiries, complaints, and grievances; resolve issues on the same day when possible
• ⚖️ Inform members of their rights, including grievance and appeals processes, fair hearings, and external review options
• 📚 Clarify information from member materials, such as 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 related to 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 as needed

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 are a plus (preferred but not required)

Core Competencies

• 💖 Customer Service Excellence: Empathetic, member-focused support skills
• 🩺 Healthcare Knowledge: Understanding of healthcare services, insurance, and managed care
• 🗣️ Communication Skills: Clear and professional verbal and written communication
• 🛠️ Problem Solving: Ability to assess issues, develop solutions, and resolve concerns efficiently
• 📊 Organization & Multitasking: Managing multiple priorities in a fast-paced environment
• 🌍 Cultural Competency: Effectively working with diverse populations and sensitive situations
• 🤝 Team Collaboration: Working effectively with interdisciplinary teams and external partners
• 🔒 Integrity & Accountability: Maintaining confidentiality and compliance standards