Medix Is Hiring A Hybrid Member Service Representative Bilingual Mandarin

Join Our Team as a Member Services Representative (Healthcare) 🩺

Provide exceptional support to members and providers while ensuring a smooth healthcare experience. If you're passionate about customer service and healthcare, this role is for you!

Position Overview

The Member Services Representative acts as the primary contact point for members and providers, delivering outstanding customer service. Your main focus will be helping members navigate their benefits, access services, resolve concerns, and enjoy a seamless 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, use their benefits, and navigate the healthcare system
• 📝 Respond to and document member inquiries, complaints, and grievances; resolve issues promptly 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 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 as needed

Qualifications

Education:

• 🎓 High School Diploma or equivalent required

Experience:

• 🩺 At least 3 years of experience in a healthcare or call center setting
• Supporting Medicaid and/or Medicare populations is preferred
• Strong computer skills, including Microsoft Office Suite
• Bilingual abilities (preferred but not required)

Core Competencies

• 💖 Customer Service Excellence: Empathetic, member-focused support
• 🏥 Healthcare Knowledge: Understanding of healthcare services and insurance
• 🗣️ Communication Skills: Clear and professional verbal and written abilities
• 🔧 Problem Solving: Assessing issues and finding effective solutions
• 🗂️ Organization & Multitasking: Managing multiple priorities efficiently
• 🌍 Cultural Competency: Working effectively with diverse populations
• 🤝 Team Collaboration: Coordinating with interdisciplinary teams and partners
• 🔒 Integrity & Accountability: Maintaining confidentiality and compliance standards