Mandarin Bilingual

Job SummaryMember 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 actionQualificationsHigh school diploma or equivalent, bachelor’s degree preferred.With or without experience as long as fluent in both Mandarin and Englishcurrently residing in the PhilippinesAt least 2 years of customer service experience, preferably in healthcare management and/or a call center setting is an advantageExceptional customer service skills, including verbal and written communicationStrong active listening skillsAbility to collaborate and be a team playerMust be a quick learnerAbility to remain calm and courteous when handling upset members and offering solutions to their problems and knowing when to escalate the callFamiliarity with Centers for Medicare and Medicaid Services (CMS) regulations, preferredProficiency 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.