Member Services Representative ; Bilingual Spanish

Member Services Representative I (Bilingual Spanish)

Location:

Alameda, CA 94502 (Onsite)

Schedule:

Monday–Friday, 8:00 AM–5:00 PM

Pay: $28.61/hr

Hiring a Member Services Representative (bilingual Spanish) to serve as a first point of contact for members in a fast-paced managed care / health plan customer service environment. This Member Services Representative position focuses on resolving benefit and eligibility questions, supporting authorizations and claims inquiries, and documenting accurately in a CRM. If you have strong call center skills and can professionally support diverse members, this Member Services Representative role is a great fit.

• Provide phone-based support for routine and complex member service issues
• Handle inbound calls and written/digital inquiries (email, chat, letters, fax) within service levels
• Educate members on benefits, eligibility, authorizations, pharmacy, and provider network questions
• Accurately document member interactions, outcomes, and follow-up steps in CRM
• Identify when issues require escalation and coordinate with internal departments for resolution
• Resolve or track exempt grievances according to required timelines and documentation standards
• Support appointment assistance and provider office outreach as needed
• Promote use of self-service tools (member portal and online resources)
• Maintain compliance, confidentiality, and professional customer service standards

• Bilingual Spanish/English required (must pass proficiency exam at required score)
• High school diploma/GED required;
  Bachelor’s degree or equivalent experience preferred
• 1+ year customer service experience (healthcare call center or managed care preferred)
• Strong written/verbal communication, de-escalation, and customer advocacy skills
• Proficiency with CRM systems, data entry, and multi-system research
• Able to work onsite in Alameda, CA, Monday–Friday, 8:00 AM–5:00 PM