Remote – Spanish Bilingual Healthcare Customer Service Representative

What You'll Be Doing

• Customer Interactions: Manage inquiries in areas such as Member Services, Medicare, and Billing.
• Represent our client professionally by addressing and documenting all incoming queries, including complex calls related to specialized product lines.
• Quality Service: Uphold the organization’s philosophy of extraordinary customer relations.
• Analyze and evaluate customer issues to initiate and coordinate service recovery measures.
• Document all member interactions meticulously following established procedures.
• Healthcare Knowledge: Demonstrate familiarity with health insurance terminology (copays, deductibles, claims, authorizations, etc.). Understand Medicare/Medicaid plans and regulations, and explain plan benefits, provider networks, and coverage policies.
• Operational Excellence: Leverage a thorough understanding of company policies and processes to meet customer needs effectively. Contribute to departmental goals and objectives while maintaining proficiency through ongoing training and use of required tools.
• Maintain Contact Center KPIs, including call handling, first call resolution, and member retention.
• Compliance and Ethics: Consistently uphold company compliance standards and Code of Conduct, ensuring privacy and confidentiality of member information. Adhere to HIPAA regulations to protect personal health information (PHI) and maintain data security.
• Leverage multiple systems/screens while assisting callers effectively. Navigate CRM, EMR/EHR, and ticketing platforms effectively.

What You Bring

• Minimum 1 year of customer service or healthcare member-interaction experience.
• Previous call center experience and/or prior experience in the health insurance industry (preferred).
• Education: High School Diploma or GED required.
• Skills: Fluent in both Spanish & English, Outstanding written and verbal communication skills, Proven analytical and problem-solving abilities, Ability to respond concisely and clearly to customer queries, Strong critical thinking and problem-solving skills, Typing speed of at least 35 WPM with a 5% or lower error rate.

Success Factors for Working from Home

• Private Workspace: A dedicated, quiet workspace with a door that closes, free from ambient noise.
• Ergonomics: A comfortable desk and chair setup that allows for the proper installation of necessary equipment.
• Reliable Internet Connection: Stable, high-speed internet with a minimum bandwidth of 20 Mbps downstream and 20 Mbps upstream.
• Quiet, Distraction-Free Workspace: A dedicated, quiet area where you can focus on delivering excellent customer service without interruptions.
• Tech-Savvy: Comfort with technology and ability to learn new systems quickly.
• Self-motivation & Independence: Ability to stay productive and manage your time effectively in a remote environment.
• Communication Skills: Strong verbal and written communication skills, especially in a virtual setting.
• Adaptability: Ability to adapt to changing technologies and procedures while working remotely.

What You Will Get

• Competitive Pay: Enjoy a competitive hourly rate with opportunities for performance-based increases.
• Comprehensive Benefits: Full health insurance coverage, including medical, dental, and vision plans.
• Work Environment: A supportive, engaging, and inclusive work environment with opportunities to grow and develop your skills.
• Career Growth: Abundant advancement opportunities within the organization.
• Inclusive Workplace: We are an Equal Opportunity Employer, welcoming individuals with disabilities and veterans.
• No Limits on Payouts: Join our team and earn $50 per paycheck for every person you refer—and your referral earns it too!