Medix™ Is Hiring A Member Service Representative Bilingual Mandarin

Join our team as a Member Services Representative (Healthcare) and be the friendly face helping members navigate their healthcare journey. 😊

Position Overview

The Member Services Representative acts as the primary point of contact for members and providers, delivering exceptional customer service and support. This role involves assisting members with understanding their healthcare benefits, accessing services, resolving concerns, and ensuring a smooth and positive 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, use their benefits, and navigate the healthcare system
• 📝 Respond to and document member inquiries, complaints, and grievances; resolve same-day issues when possible
• 🛡️ 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 diverse individuals using interpretation services and adaptive communication 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 Microsoft Office Suite
• 🗣️ Bilingual skills are a plus but not required

Core Competencies

• Customer Service Excellence: Provide empathetic, member-focused support 🤗
• Healthcare Knowledge: Understand healthcare services, insurance, and managed care
• Communication Skills: Demonstrate clear, professional verbal and written communication
• Problem Solving: Assess issues, identify solutions, and resolve concerns efficiently
• Organization & Multitasking: Manage multiple priorities in a fast-paced environment
• Cultural Competency: Work effectively with diverse populations and sensitive situations
• Team Collaboration: Collaborate seamlessly with interdisciplinary teams and external partners
• Integrity & Accountability: Maintain confidentiality and adhere to compliance standards