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Astrana Health, formerly known as ApolloMed, is a leading risk-bearing, technology-powered health company. The company operates an integrated healthcare deliver
Customer Service Representative, Cantonese/Mandarin Speaking
Location
California
Posted
58 days ago
Salary
$18 - $24 / hour
Seniority
Junior
Job Description
Customer Service Representative, Cantonese/Mandarin Speaking
Astrana Health
• 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 • Conduct 3 way conference call to Health Plan with member • Conference call with Providers – Appointments, DME, • COVID – 19 related questions (Tests & Vaccines) • Direct Member Reimbursement (DMR) • Eligibility – Demographic changes: Address/Phone/Fax Changes/Name change • Escalated calls from providers/members • Health Diary Passport • Health Source MSO – Assist & arrange inquiries on Eligibility/Change PCP/Benefit with AHMC • HIPPA Consent – Obtain Member Consent verification • Inquiries on provider network/provider rosters • Lab locations • Member & Provider Complaints/Grievances • Member bills • Miscellaneous calls • Pharmacy – Drug/medication pick up and coverage • Provide authorization status for Hospital /CM Dept • Self-Referral Request for Medicare • Return Mail • Track Mail Packages/ Certified mail status • Translations – Spanish / Chinese • Urgent Care / locations/ operations hours • Assist to contact new members/IPA member transfer on new PCP assignment as needed • Work group discussions on work status/progress on new member/IPA transfer • Update call log and provide daily/weekly status as needed • Facilitate members with complex pre-existing conditions, medications, PCP/SPC network reviews • Conference call with PCP selection / change • Help member to identify member bill status, connect provider with on billing and claim submission • Responsible for experience of the membership associated with new member/IPA transfer • Responsible for to interact with Health Plan’s Customer Service Team to serve new member/IPA transfer • Problem Solving complex cases/ brain storm with MS management team for resolution • Other duties as assigned
Job Requirements
- High School Diploma or GED
- Experience using Microsoft applications such as Word, Excel and Outlook
- Experience working in customer service
- One year related experience and/or training; or equivalent combination of education and experience
- You are fluent in Cantonese or Mandarin
- You're a great for this role if:
- You have previous work experience working in a healthcare setting
Benefits
- This is a remote role. The home office is aligned with your department at 9700 Flair Drive, El Monte, CA 91731
- This position will typically work Monday - Friday from 8:30am to 5:00pm PST.
- The target pay range for this role is $18.90 - $24.25 per hour. This salary range represents national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
- 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 humanresourcesdept@astranahealth.com 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.
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