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SCAN

SCAN is a mission-driven organization that is tackling some of the biggest issues in health care for older adults.

Bilingual SAL Advocate

BilingualBilingualFull TimeRemoteMid LevelTeam 1,001-5,000Since 1977H1B SponsorCompany SiteLinkedIn

Location

California

Posted

37 days ago

Salary

$20 - $21 / hour

Seniority

Mid Level

High School2 yrs expChineseKoreanVietnameseEnglish

Job Description

Bilingual SAL Advocate

SCAN

• Serves members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals, claims and any other aspects of plan benefits and services. • Ensures member satisfaction by providing superior customer service and willingness to help at all time while maintaining a professional demeanor. • Provides quality customer service by applying SCAN Five Service Principles. • Educates members, family, providers and caregivers regarding benefits and plan options. • Accurately explains benefits and plan options in person, via email or telephonically. • Provides follow-up with members by clarifying customer's issue, determining the cause, and identifying and explaining the solution. • Escalates appropriate member issues to management or other departments as required. • Consistently meets and/or exceeds the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance. • Responds appropriately and in a timely fashion to member/internal staff/providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues following departmental policies and procedures and job aids. • Takes ownership of the issue, focusing on providing solutions and options for member, as necessary through resolution of member issue. • Increases member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion; coordinates resolution with providers and other departments as needed. • Participates in member calling projects as assigned by management to support the overall SCAN goal of membership retention. • Follows policies and procedures and job aids in order to maintain efficient and complaint operations; communicates suggestions for improvement and efficiencies to management; identifies and reports problems with workflows following proper departmental procedures; actively participates in departmental staff meetings and training sessions. • Follows all appropriate Federal and State regulatory requirements and guidelines applicable to Scan Health Plan operations, as documented in company policies and procedures. • Follows all HIPAA requirements. • Documents transactions by completing applicable member forms and summarizing actions taken in appropriate computer system and following standards set by the department or by other authorized individuals. • Temporarily responds to routine member questions and concerns on specific medical group call queues as part of skill development. • Contributes to team effort by accomplishing related results as needed.

Job Requirements

  • 1-2 years call center or related customer service experience, required.
  • 1-2 years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred.
  • Experience in the healthcare, insurance or pharmacy industry high desirable.
  • Ability to maintain calm demeanor at all times, including during highly charged situations.
  • Data entry and general computer skills (word processing, e-mail) required.
  • Effective communication (oral and written) skills.
  • Professional/pleasant telephone manner required.
  • Ability to handle large call volume, while providing excellent customer service at all times required.
  • Demonstrated efficiency/effectiveness in an environment with a high call volume.

Benefits

  • An annual employee bonus program
  • Robust Wellness Program
  • Generous paid-time-off (PTO) - 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
  • Excellent 401(k) Retirement Saving Plan with employer match
  • Robust employee recognition program
  • Tuition reimbursement

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