Medix Is Hiring A Member Service Representative Bilingual

Discover an exciting opportunity to join a dedicated healthcare team as a Hybrid Bilingual Member Service Representative (Mandarin & English). This role combines compassionate customer service with healthcare expertise in a dynamic hybrid work environment.

Job Details

• Job Title: Hybrid Member Service Representative (Bilingual Mandarin Required)
• Job Type: Full-Time
• Schedule: Hybrid
• Location: New York, NY

Position Overview

We are seeking a compassionate, detail-oriented, and customer-focused Member Service Representative fluent in both English and Mandarin. In this role, you will support members and providers by navigating healthcare services and benefits, ensuring they receive exceptional service and understand their healthcare coverage. Your efforts will help members access the resources they need to maintain their health and well-being.

The ideal candidate will possess strong communication skills, healthcare customer service experience, and the ability to work collaboratively with interdisciplinary care teams, providers, and families.

Key Responsibilities 🚀

• Handle incoming calls and respond to inquiries from members and providers regarding covered and non-covered services in relation to the member's plan of care
• Conduct post-enrollment orientations for members, families, and authorized representatives
• Explain plan rules and procedures for obtaining services; assist members with scheduling appointments with primary care physicians and specialists
• Address member questions, concerns, and grievances; educate members on their rights, including filing complaints with the Department of Health or other entities
• Clarify information in the member handbook and online resources
• Educate members on the grievance and appeals processes, service authorization procedures, fair hearing rights, and external review options
• Log, track, and resolve member and provider grievances, aiming to resolve same-day when possible
• Facilitate communication among members, providers, subcontractors, and Care Managers
• Make medication reminder calls under the direction of the Interdisciplinary Care Team
• Assist members in selecting participating healthcare providers
• Support the Interdisciplinary Care Team with non-clinical assessments
• Enter service authorizations following care team guidance
• Communicate effectively with members with special needs using interpretation and accessibility tools
• Assist members with Medicaid benefit renewals
• Participate in special projects and departmental initiatives as needed

Qualifications ✅

• Bilingual in Mandarin and English (spoken and written) required
• High school diploma or equivalent; Associate's or Bachelor's degree preferred
• Previous experience in healthcare, managed care, insurance, or member services strongly preferred
• Knowledge of Medicaid, Medicare, or MLTC is a plus
• Strong problem-solving, communication, and conflict resolution skills
• Excellent organizational skills and attention to detail
• Ability to handle sensitive and confidential information professionally
• Proficiency in Microsoft Office and data entry systems
• Ability to work independently and as part of a team in a hybrid environment

Preferred Skills 🌟

• Experience working with diverse and underserved populations
• Knowledge of grievance and appeals processes
• Understanding of care coordination and member advocacy
• Empathy and dedication to delivering high-quality member support

Join Us in Making a Difference 🤝

We are looking for someone passionate about helping others and committed to enhancing the member experience through excellent service and support.

For California Applicants 📋

We consider all qualified applicants, including those with criminal histories, in accordance with federal, state, and local laws such as the Fair Chance Initiatives and Ordinances in Los Angeles and San Francisco, as well as the California Fair Chance Act. Please note that this position requires a background check due to responsibilities involving patient care, working with vulnerable populations, and access to confidential information.

Company About Medix 🏢

At Medix, we are dedicated to providing innovative workforce solutions across multiple industries. Recognized as one of the Best and Brightest Companies to Work For for two consecutive years and ranked as one of the fastest-growing companies by Inc. Magazine, our mission is to positively impact 20,000 lives. Our success is driven by our teams' hard work and dedication. Are you ready to lock arms with us?