Description / Requirements

URGENT HIRING OF OUR NEW CLIENT!

Position Title: Member Advocate I

Position Type: Full Time

Location: 6th Floor, The Orient Sq bldg., F. Ortigas Jr. Road, Ortigas Center, Pasig, 1605

Work Set-up: Onsite

Reports To: Call Center Supervisor

Salary: To be discussed (please source candidates with a salary range of 80K-95K Native Koreans)

Visa to be processed by the company for expats

About Clever Care Health Plan

Clever Care Health Plan is a newly founded Medicare Advantage health plan, that will serve Medicare beneficiaries in Southern California. Our employees are passionate about providing the best services to our members and healthcare provider partners. Two office locations are Arcadia, Los Angeles County, and Westminster, Orange County. To learn more, please visit CleverCareHealthPlan.com.

Job Summary

Member Advocates are the main point of contact at Clever Care; interfacing with members, prospective members, providers, brokers, and vendors. Serves members by being the main point of contact at Clever Care for member questions and concerns regarding benefits, eligibility, referrals, claims, and any other aspects of plan benefits and services. A successful Member Advocate, I ensure member satisfaction by providing superior customer service and displaying a willingness to help at all times while maintaining a professional demeanor.

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

Qualifications (Updated)

High school diploma or equivalent, bachelor’s degree preferred.

With or without experience as long as fluent in both Korean and English currently residing in Philippines

At least 2 years of customer service experience, preferably in healthcare management and/or a call center setting is an advantage

Exceptional customer service skills, including verbal and written communication

Fluent in both Korean and English

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)

Responsibilities:

Educates members, family, providers and caregivers regarding benefits and plan options.

Accurately explains benefits and plan options in person, via email, fax, or telephonically.

Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution. Escalates appropriate member issues to management or other departments as required.

Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution.

Escalates appropriate member issues to management or other departments as required.

Participates in member-calling projects as assigned by management to support the overall company goal of membership retention.