Customer Service Rep - Chinese Bilingual

Job Description

Job Description

Role Insights

The Bilingual Chinese Customer Service Representative I provides English/Chinese language support to members, healthcare providers, health plans, and internal departments.

This position is based in our Long Beach office and supports markets outside of California, including New York, Georgia, Washington, and Hawaii.

This is a dynamic, fast-paced role that demands energy, professionalism, compassion, empathy, cultural sensitivity, and a strong commitment to delivering exceptional, service-focused experiences. Success in this position requires fluency in English and Mandarin, Cantonese, and/or Toishanese, along with confidence in problem-solving, sound judgment, and the ability to resolve issues promptly and effectively.

In addition to handling inbound calls, representatives are responsible for conducting timely follow-up outreach to ensure issues are fully resolved. Strong time-management and organizational skills are essential to balance call volume with follow-up responsibilities throughout the day.

Performance in this role is measured through key performance indicators (KPIs), including call metrics, first-call resolution, escalation rates, documentation accuracy, and overall service quality.

Primary Responsibilities

• Manage a high volume of routine inbound calls in English and Mandarin, Cantonese, and/or Toishanese from members, brokers, healthcare providers, and health plans regarding claim status, eligibility, service authorizations, benefits, case management, and other service-related matters.

• Provide clear, accurate, and culturally sensitive assistance to Chinese-speaking members and callers.

• Verify and communicate member eligibility and benefits and provide accurate, timely information regarding access to services.

• Provide claim status updates, complete check tracers, guide callers to the appropriate portal when applicable, and resolve routine inquiries during the initial call whenever possible.

• Research, analyze, and resolve issues related to claims, eligibility, case management, authorizations, and other customer-related requests, ensuring thorough and timely resolution.

• Conduct outbound follow-up calls in English and Mandarin, Cantonese, and/or Toishanese, taking full ownership to ensure the completion and resolution of outstanding issues.

• Assist with translating or explaining general service-related information between English and Mandarin, Cantonese, and/or Toishanese while maintaining accuracy, confidentiality, and compliance with organizational policies.

• Escalate complex or unresolved issues to senior representatives (CSR II/III) or the appropriate department as needed.

• Accurately document all interactions, actions taken, and outcomes in English within CRM/EHR and proprietary systems.

• Monitor trends in call types, dispositions, language-access needs, or recurring issues and proactively communicate observations to management.

• Meet or exceed established performance metrics, including call metrics, quality standards, documentation accuracy, and first-call resolution.

• Perform additional duties as assigned.

Required Skills and Abilities

• Bilingual fluency in English and Mandarin, Cantonese, and/or Toishanese is required, including the ability to speak and communicate clearly and professionally in the applicable languages.

• Ability to accurately explain healthcare-related terminology and information in English and Mandarin, Cantonese, and/or Toishanese.

• High school diploma or GED required; associate degree or higher preferred.

• Minimum of two years of call center or customer service experience strongly preferred.

• At least one year of experience in a healthcare or medical environment preferred.

• Working knowledge of managed-care concepts, including HMO and IPA structures, and HIPAA compliance requirements preferred.

• Strong verbal and written communication skills, with the ability to convey information clearly and professionally.

• Positive and professional attitude with strong interpersonal and customer service skills, including active listening, empathy, an upbeat tone and presence, professional call control, appropriate probing questions, confirmation of the caller’s request, and strong cultural sensitivity and awareness.

• Demonstrates critical-thinking and problem-solving skills, with the ability to assess situations and provide timely and effective solutions.

• Excellent time-management and organizational skills in a fast-paced, high-volume environment.

• Ability to follow scripts, standard workflows, and established procedures while maintaining service quality.

• Self-motivated with a strong work ethic and results-driven mindset.

• Proficiency in Microsoft Office applications and CRM/EHR systems.

• Strong data-entry skills with a high level of accuracy and attention to detail.

• Reliable and consistent attendance, with the ability to work a standard schedule, such as Monday through Friday from 8:00 AM to 5:00 PM.

Decision-Making and Scope of Authority

• Independently resolves routine inquiries and standard customer issues in English and Mandarin, Cantonese, and/or Toishanese with kindness, compassion, and empathy.

• Exercises basic to moderate decision-making authority within established guidelines, scripts, and standard workflows.

• Follows established procedures and uses sound judgment to ensure compliance with organizational policies, HIPAA requirements, and other applicable regulations.

• Seeks guidance when needed to ensure the accurate and complete resolution of customer concerns.

• Appropriately escalates complex, non-routine, or unresolved issues to CSR II/III or leadership.

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

• Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
• Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
• Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
• Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.
• Career Development: Tuition reimbursement to support your education and growth.
• Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!