More jobs:
Customer Service Representative ; Cantonese or Mandarin Speaking
Job in
El Monte, Los Angeles County, California, 91731, USA
Listed on 2026-02-08
Listing for:
Astrana Health, Inc.
Full Time
position Listed on 2026-02-08
Job specializations:
-
Customer Service/HelpDesk
Bilingual -
Healthcare
Job Description & How to Apply Below
Customer Service Representative I (Cantonese or Mandarin Speaking)
Department: Ops - Member Services
Employment Type: Full Time
Location: 9700 Flair Drive, El Monte, CA 91731
Reporting To: Zoey Fu
Compensation: $20.00 / hour
Description
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.
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
- 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 (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
Member/Provider/Health Plan/Vendor/Hospital/Broker:
- Assist Case Management on CCS - age in 21 years for change of PCP from Pediatrics to FP/IM
- Assist Marketing on email inquiries
- Assist PR/ Elig - Members assigned to wrong PCP/with no PCP status
- Assisted UM / Medical Directors on urgent member appointment from escalated cases
- Authorization status response call back
- Benefits - return call once information is obtained / verified
- Complaints/Grievances - return calls once resolution is obtained
- DME - Translation support in Spanish and Chinese to confirm item / appointment set up for DME department
- Eligibility - return call to providers/labs when member is added to system while waiting at the office.
- Member bills - return calls once resolution is obtained
- Member Survey - Annually: every 4thquarter
- Outreach project from internals - QCIT
- Resolve walk in members concerns
- Specialist Termination notification sent to members
- Transportation arrangement for Medicare / Medi-Cal members
- Voice mail - return calls back to callers
- 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
- 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 Mandarin or Cantonese
- You have previous work experience…
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