Bilingual Commercial Health Call Center Representative
We will only consider candidates in the United States who reside in the CST or EST time zones., CST, ESTFull-TimeMiddle
Salary not disclosed
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Job Details
- Languages
- English, Spanish
- Experience
- Minimum of 2 years
- Required Skills
- SalesforceCustomer serviceMicrosoft Office
Requirements
- Minimum 2 years customer service experience in commercial health plans.
- Fluency in English and Spanish.
- Knowledge of medical/insurance terminology (CPT/ICD-10, HCPCS, Revenue Codes).
- Proficiency in Microsoft Office (Word, Excel, Outlook, OneNote).
- Experience with CRM software (SalesForce preferred).
- Strong communication and problem-solving skills.
- Residency in the United States (CST or EST time zones).
- Dedicated work area ensuring information privacy.
- Access to high-speed internet.
Responsibilities
- Research and respond to inquiries from members and providers.
- Handle inbound and outbound calls and email inquiries professionally.
- Manage department escalations with urgency and accountability.
- Leverage company policies, benefits, and claims data to provide accurate responses.
- Handle member complaints and appeals.
- Coordinate with internal departments and vendors for problem-solving.
- Accurately document all customer interactions.
- Identify trends in call types and propose process improvements.
- Maintain established production and quality standards.
- Assist members with navigating the company portal.
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