Bilingual Customer Care Rep - Remote - 1st shift!

Important things YOU should know

• Must be fluent in Spanish
• Fully remote opportunity
• Experience with Dental or Health insurance a preferred plus!
• Training schedule: 8:00am- 4:30pm CST Monday – Friday for the initial 90 days
• Work schedule (after training): 8:30am - 5:00pm CST - Mon - Fri
• Hours of operation: 6:00am - 10:00pm CST so shift could flex based on business need
• Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31
• $2.00/hour differential on Mon/Tues
• Exceptional professional growth in a fun rewarding environment

What will YOU be doing for us?

Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience.

What is in it for YOU?

* Career growth in an inclusive culture * Paid training * Health benefits 401(k) *

What will YOU be working on every day?

* Servicing our Dental and Vision callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area, * Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests. * Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution. * Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information. * Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing appeals and grievances. * Provide updates to providers with questions regarding the status of their credentialing application. * Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available. * Ensure all calls are answered according to company and client guidelines. * Accurately document call information and resolution in our internal systems. * Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported. Properly identify issues that need to be escalated appropriately to the leadership team. *

Additional Responsibilities

* Provide recommendations on system enhancements and process improvements to management. * Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues. Participate in departmental projects when applicable. *

What qualifications do YOU need to have to be GOOD candidate?

Required Level of Education, Licenses, and/or Certificates

High school diploma or equivalent

*

Required Level of Experience

1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail

*

Required Knowledge, Skills, and Abilities

* Must be fluent in Spanish * Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook * Ability to work occasional overtime as needed * Excellent listening and communication skills * Superior customer service skills including the natural ability to provide empathy * Strong data entry/typing skills * Strong navigation skills and the ability to multi-task * Excellent attention to detail * Critical thinking skills to quickly analyze and clearly understand a specific request or customer need Leverage knowledge and resources to provide the appropriate solutions *

What qualifications do YOU need to be a GREAT candidate?

Preferred Level of Experience

• 1+ years of job related customer service experience within the dental, vision or medical industry
• Previous experience working in a virtual environment
• Understanding of dental, vision and/or medical insurance terminology
• Previous call center experience