Customer Service Representative (Cantonese or Mandarin Speaking)

Job Title: Customer Services Representative Department: Operations - Member Services About the Role: Astrana is looking for a Customer Service Representative to join our fast and growing Dynamic team. This position requires speaking fluent in Cantonese or Mandarin to assist with our member population. 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/ 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