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Bilingual Customer Service Specialist
2 months ago
As a Bilingual Customer Service Specialist, you will play a crucial role in facilitating communication between members, providers, and health plans. Your expertise will ensure that all inquiries are handled efficiently and effectively.
Key Responsibilities:
- Engage directly with members, providers, and health plans to address their needs.
- Verify benefits and eligibility information for all parties involved.
- Confirm the participation status of providers within the network.
- Provide updates on claim statuses to members and providers.
- Identify customer complaints and determine the best course of action to resolve issues, escalating to management when necessary.
- Keep management informed of any significant issues that require attention.
- Utilize critical thinking and problem-solving skills to address inquiries.
- Manage multiple tasks and prioritize effectively to enhance service delivery.
- Respond to general questions regarding plan benefits, limits, co-pays, deductibles, and reimbursement policies.
- Ensure follow-up on unresolved issues, keeping all parties informed of progress.
- Strive to assist the maximum number of callers efficiently while maintaining high service quality.
Qualifications:
- Minimum of 1 year of experience in Member Services within the Healthcare sector.
- Proficient in computer usage.
- Bilingual in English and Spanish.
Work Schedule:
Monday to Friday, with operational hours from 8:00 AM to 7:00 PM EST.
Preferred Qualifications:
Strong familiarity with health plan terminology is highly desirable.
Compensation:
The compensation for this role is competitive and may vary based on experience and other relevant factors. This position may also include eligible bonuses and commissions.