Customer Service Representative/ Bilingual

Customer Service Representative, Bilingual The Customer Service Representative, Bilingual, assists members, physicians, hospitals, revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals. The Customer Service Representatives must be able to work in various shifts Monday to Friday between the hours of 9AM 7PM EST with the ability to adjust shifts with notice based on business needs. Handle inbound calls from members, medical providers, and others. Adjust claims accurately, if needed. Listen to and address customer needs and concerns empathetically. Answer questions about fee schedules, network participation, and requirements. Update customer files and communicate effectively with teams. Contribute to customer satisfaction and business improvement. Use decision-support tools to provide accurate responses. Investigate inquiries using training and systems. Support projects and other departments as directed by management. High School diploma with some college or business school education preferred. Fluent in both Spanish and English. Basic computer operations knowledge. Intermediate proficiency in Microsoft Office (Word, Excel, Access, PowerPoint, Outlook). Quick learner with ability to grasp managed care procedures and claims payment policies. Flexible and adaptable to changes, with conceptual thinking. Comfortable performing tasks at a computer/telephone station. Effective communication through various channels, including email, chat, and voice. About Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you'll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today's healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today's challenges into tomorrow's solutions. Company Mission Transform the health plan experience how health care is accessed and delivered by bringing outstanding products and services to our partners. Company Vision Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways. We are building, nurturing and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level. *We are an Equal Opportunity Employer Annual Salary Range: $45,760
- $47,840 The salary range and/or hourly rate listed is a good faith determination that may be offered to a successful applicant for this position at the time of the posting of an advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable by law including but not limited to location, years of relevant experience, education, credentials, skills, budget and internal equity. Brighton Health Plan Solutions