Member Services Representative I (Tagalog Bilingual) - {178071}

Member Services Representative I (Tagalog Bilingual) – Call Center

Location: Alameda, CA 94502 (On-site)
Schedule: Monday–Friday, 8:00 AM–5:00 PM
Pay: $28.61/hr

Summary

Now hiring a Member Services Representative to support a fast-paced health plan call center. This Member Services Representative role is ideal for a customer-focused professional who can manage high call volume, research member benefits, and document interactions accurately while following healthcare regulations. If you’re fluent in Tagalog + English, enjoy solving problems, and thrive in a metrics-driven environment, this Member Services Representative opportunity offers stable weekday hours and meaningful work helping members navigate coverage, benefits, and services.

Responsibilities

• Answer high-volume inbound/outbound calls and respond to member/provider requests via phone, email, fax, letters, and chat
• Resolve inquiries related to benefits, eligibility, claims, authorizations, pharmacy, plan services, and managed care guidelines
• Research complex issues across multiple systems/databases and coordinate with internal departments to drive resolution
• De-escalate dissatisfied callers and provide professional, empathetic customer support
• Document all interactions accurately in CRM and electronic databases (including timely tracking/closure of service requests)
• Prepare and send member communications and materials as needed
• Educate members on plan rules, provider selection, and self-service resources (member portal/website tools)
• Support service excellence metrics including quality, compliance, member satisfaction, first-call resolution, punctuality, and attendance

Qualifications

• Bilingual Tagalog/English required (must pass proficiency exam with 90%+)
• High school diploma or GED required (Bachelor’s degree preferred or equivalent experience)
• 1+ year of direct customer service experience (call center and managed care experience preferred)
• Strong computer skills; comfortable navigating multiple applications (CRM, PBM tools, phone system software)
• Excellent communication, active listening, and documentation skills (accurate notes and clear case records)
• Ability to manage competing priorities in a high-volume, deadline-driven environment
• Knowledge of healthcare benefits/eligibility/authorization processes is a plus
• Able to maintain confidentiality and comply with healthcare regulatory requirements