Call Center Representative – Bilingual

This is a fully remote position, open to applicants in United States.

📋 Description

• Engage directly with members, healthcare providers, and health plans.

• Verify benefits and eligibility details.

• Validate participating providers within the network.

• Provide updates on claim statuses.

• Address customer complaints and escalate issues as needed.

• Keep managers apprised of matters that need attention.

• Utilize knowledge, experience, common sense, and critical thinking to resolve customer inquiries.

• Manage multiple tasks and prioritize effectively.

• Respond to general questions regarding plan benefits, limitations, co-pays, deductibles, policy procedures, and reimbursements.

• Redirect callers when necessary.

• Follow up on unresolved matters until they are resolved and keep all parties informed.

• Efficiently assist the maximum number of callers without compromising service quality.

⛳️ Requirements

• Minimum of 1 year of experience in Member Services within the healthcare sector.

• Proficient in computer use.

• Bilingual in English and Spanish.

• For remote or hybrid positions, exhibit a high level of engagement in virtual settings, including maintaining camera presence during meetings.

• Strong grasp of health plan terminology (preferred skill).

🏝️ Benefits

• Potential bonuses and commissions may be included in the compensation package.

• Access to iCare benefits (specific benefits linked separately).

• Flexible remote or hybrid work options.

• Maintain camera presence during virtual meetings to enhance communication and team alignment.