Customer Service Representative (Bilingual Korean)

Must be available to work from 11:30 AM to 8:00 PM on a hybrid schedule and reside in Los Angeles or Orange County.

About Us

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values. We are one of Southern California’s fastest-growing Medicare Advantage plans with 112% year-over-year membership growth, reflecting our commitment to making healthcare accessible for underserved communities.

About the Role

Member Advocates are the main point of contact at Clever Care, interfacing with members, prospective members, providers, brokers, and vendors. This role serves members by addressing questions and concerns regarding benefits, eligibility, referrals, claims, and other aspects of plan benefits and services. A successful Member Advocate I ensures member satisfaction through superior customer service while maintaining a professional demeanor.

Responsibilities

• Educates members, family, providers, and caregivers regarding benefits and plan options in person, via email, fax, or telephone.
• Provides follow-up with members by clarifying issues, determining causes, and identifying solutions.
• Escalates appropriate member issues to management or other departments as required.
• Participates in member calling projects to support membership retention.
• Follows policies, procedures, and job aids to maintain efficient and compliant operations; communicates suggestions for improvement to management.
• Follows all Federal and State regulatory requirements, including HIPAA guidelines.
• Documents transactions by completing member forms and summarizing actions in the appropriate computer system.
• Works in an environment where continuous coaching and feedback is standard practice.
• Performs other duties as assigned.

Requirements

• High School Diploma or equivalent required; Bachelor’s Degree or equivalent work experience preferred.
• Two (2) years of customer service experience, preferably in healthcare management and/or a call center setting.
• Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations.
• Bilingual in Cantonese, Mandarin, Vietnamese, Korean, Spanish, Thai, Khmer, or Japanese may be required.
• Exceptional customer service skills, including verbal and written communication.
• Strong active listening skills and ability to collaborate as a team player.
• Ability to remain calm and courteous when handling upset members and knowing when to escalate calls.
• Ability to listen, talk, and type simultaneously.
• Proficiency with Microsoft Office (Word, Excel, Outlook).
• Type 40 wpm (60 wpm preferred).
• Must be willing and able to work some weekends from October to March.

Physical & Working Environment

• Must be able to travel when needed or required.
• Ability to operate a keyboard, mouse, phone, and perform repetitive motion (keyboard); writing (note-taking).
• Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.
• Ability to express or exchange ideas to impart information to the public and convey detailed instructions accurately and quickly.
• Work is performed in an office environment and/or remotely, with frequent contact with staff and the public.
• May occasionally be required to work irregular hours based on business needs.

Pay

Wage range: $20.00 to $23.00 per hour. Salary ranges are based on California wages and may vary depending on the candidate’s state of residency.