Customer Care Representative
New
J
Judi HealthHealth Technology
Remote, Monday thru Friday, 9:00am – 5:30pm, EasternFull-TimeMiddle
Salary26 USD per hour
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Job Details
- Languages
- Bilingual Spanish highly preferred
- Experience
- 2+ years
- Required Skills
- Customer serviceHIPAA
Requirements
- High school diploma or equivalent (Associates or Bachelor’s degree preferred).
- 2+ years of customer service, call center, or health care experience.
- 2+ years of medical claims or related health care experience.
- Proficiency in building customer loyalty through listening and communication.
- Ability to work independently with minimal supervision.
- Experience working in a high-volume, fast-paced, metric-driven call center environment.
- Bilingual Spanish language skills (highly preferred).
- Medicare experience (preferred).
- Ability to work with multiple systems and multitask using at least 2 monitors.
Responsibilities
- Efficiently triage incoming phone calls from members, pharmacies, and providers with professional etiquette.
- Ask probing questions to identify, resolve, or escalate issues regarding medical and pharmacy claims.
- Communicate solutions to members, pharmacies, providers, and internal stakeholders to ensure quality care.
- Ensure first-call resolution and de-escalate customer concerns with compassion.
- Adhere to HIPAA guidelines, company policies, and Standard Operating Procedures.
- Support the Fraud, Waste, and Abuse program by reviewing and communicating claims findings.
- Meet departmental goals regarding schedule adherence, attendance, and quality monitoring.
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