Member Services Representative *Vietnamese Bilingual*
Description
Job Title: Member Services Representative
Department: Strategy & Operations
About the Role: Astrana Health is looking for a Member Service Representative to join our fast and growing Dynamic team.
What You'll Do:
- Answer all daily telephone calls from members, providers, health plans, insurance brokers, collection agents and hospitals
- Collect Elicit information from members/providers including the problem or concerns and provide general status information
- Verify authorization, claims, eligibility, and status only
- All calls carefully documented into Company’s customer service module & NMM Queue system
- Member/Provider Service/Representative assists Supervisor and Manager with other duties as assigned
- Member outreach communications via mail or telephone
- Assist Member appointment with providers
- Resolve walk-in member concerns
- Able to provide quality service to the customers
- Able to communicate effectively with customers in a professional and respectful manner
- Maintain strictest confidentiality at all times
- Specialist termination notifications sent to members
- Urgent Medicare Authorization Approval – Notification to Medicare members
- Transportation arrangement for Medicare & Medi-Cal members
- Outreach Project Assignments
INBOUND CALLS:
Member/Provider/Health Plan/Vendor/Hospital/Broker:
- All calls carefully documented into Company’s customer service module
- Annual Wellness Visit (AWV) – Gift card pick up and schedules
- Appointment of Representative (AOR) for Medicare Members
- Attorney / Third Party Vendor calls
- Authorization status/Modification/Redirection/CPT Code changes/Quantity adds/Explain Denied Auth/Peer to Peer calls/Extend expired auth/Pre-certified auth status/Retro/2ndor 3rd opinion/
Qualifications:
- 2+ years of healthcare experience
- High School Diploma or GED
- Experience using Microsoft applications such as Word, Excel, Adobe, and Outlook
- Experience working in customer service
- One year related experience and/or training; or equivalent combination of education and experience.
- Bilingual in Vietnamese
You're a great for this role if:
- Has knowledge of Medicare Advantage
- Has Ez-Cap experience
Who We Are:
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise in order to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 10,000 physicians to provide care for ~ 1 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise in order to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Our Values:
- Patients First
- Empowering the Independent Provider
- Be Innovative
- Operate with Integrity & Deliver Excellence
- Team of One
Environmental Job Requirements and Working Conditions:
- This position is in office. The office is located at "2690 S. White Road, Suite 10, San Jose, CA 95148."
- There is also an on-field expectation to assist with marketing events.
- The total compensation target pay range for this role is $18.00 - $23.00 per hour. This salary range represents national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.