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Full Job Description
About Clever Care Health Plan
Clever Care Health Plan is a Medicare Advantage health plan currently serving Medicare beneficiaries in Southern California. Our employees are passionate in providing best services to our members and healthcare providers. We deliver on our commitment to our members’ health and well-being by offering plans that connect the benefits of Eastern and Western medicine. To learn more, please visit CleverCareHealthPlan.com.
Member Services Representatives are the main point of contact at Clever Care; interfacing with members, prospective members, providers, brokers, and vendors. A successful Member Services Representative is polite, courteous, able to solve problems quickly and effectively, and focused on providing a positive and lasting impression.
Member Services Representatives are expected to assess the needs of the caller and determine, based on strong operational understanding, the most appropriate and effective course of action.
Functions & Job Responsibilities
Manage inbound and outbound calls, faxes, and emails in a call center environment
Assists members, providers, medical groups, vendors, and other delegates in addressing their needs, complaints, and other issues with services and access to care
Responds efficiently and accurately to callers and explains possible solutions
Engages in active listening with callers, confirming or clarifying information and diffusing angry members as needed
Follows communication scripts when handling different topics
Builds sustainable relationships and engages members by going the extra mile
Keep records of all conversations in our central database
Additional projects assigned by management
Qualifications
High school diploma or equivalent, Bachelor’s Degree preferred
At least 2 years customer service experience, preferably in healthcare management and/or a call center setting
Bilingual in one of the following languages: Cantonese, Mandarin, Vietnamese and/or Korean.
Exceptional customer service skills, including verbal and written communication
Strong active listening skills
Ability to collaborate and be a team player
Must be a quick learner
Ability to remain calm and courteous when handling upset members and offering solutions to their problems and knowing when to escalate the call
Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations, preferred
Proficiency with Microsoft Office (Word, Excel, Outlook)
Type 60wpm preferred
Must be willing and able to work weekends from October-March
What's in it for you? Benefits!
A competitive compensation and benefits program.
Generous paid-time-off (PTO).
Ten paid holidays per year.
Excellent 401k saving plan, providing up to 4% match and employer contribution match is 100% immediately vested.
A work-life balance and much more!
Physical & Working Environment.
Typical Physical Demands.
Position requires a great amount of sitting and standing. Some standing, stooping, bending or reaching is required. May require lifting up to 15 pounds. Requires manual dexterity sufficient to operate a computer, calculator and telephone. Requires normal range of hearing and vision. Requires the ability to type and file.
Typical Working Conditions.
Work is performed in an office environment. Work may be stressful at times. May occasionally work some irregular hours.
Job Type: Full-time
Application Question(s):
Please confirm your email address.
Education:
High school or equivalent (Preferred)
Experience:
Customer Service: 2 years (Preferred)
Language:
Korean (Required)