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Multilingual Healthcare Support Specialist

2 months ago

Dalton, Georgia, United States Alliant Health Plans Full time

Job Summary

The Bilingual Customer Service Representative at Alliant Health Plans addresses inquiries, questions, and concerns in all areas, including enrollment, eligibility, claims, benefit interpretation, and referrals/authorizations for medical care. This role is responsible for receiving, responding to, and directing member, broker, and provider communications, providing available information upon request, and escalating issues as appropriate.

Key Responsibilities

  • Receives customer calls or inquiries, routes them appropriately, and provides timely and accurate information.
  • Processes customer requests according to established department policies and procedures.
  • Completes research and investigative activities to address customer inquiries.
  • Works closely with other departments to gather information.
  • Provides timely feedback to customers through various channels.
  • Assists in the completion of special projects and assists in the documentation, evaluation, and revision of department policies and procedures.
  • Meets or exceeds service level agreements in call center metrics.
  • Attends and participates in meetings and trainings as required.

Requirements

  • Requires a high school diploma or its equivalent.
  • Related experience is preferred.
  • Bilingual in Spanish and English.
  • Confidentiality and time management skills.
  • Ability to learn quickly and be self-motivated.
  • Knowledge of healthcare billing and claims is preferred.
  • Insurance experience is preferred.

Competencies

  • Ethics: Honest, accountable, maintains confidentiality.
  • Reliability: The extent to which the employee can be depended upon to be available for work, do it properly, and complete it on time.
  • Sense of Urgency: Meets deadlines, establishes appropriate priority, gets the job done in a timely manner.
  • Customer Service: Works well with customers, promotes a positive image of the company, strives to solve issues raised by customers.
  • Skills: Possesses effective communication skills: oral, written, listening.
  • Computer Skills: Skilled with computers, takes advantage of new technology, learns new tools quickly, uses technology to enhance job performance.
  • Conflict Management: Good listener, committed to finding solution to problems, works well with difficult people.
  • Cooperation: Willingness to work harmoniously with others in getting a job done.
  • Initiative: Takes action, seeks new opportunities, strives to see projects to completion.
  • Job Knowledge: Knowledge of products, policies, and procedures.
  • Organizational Skills: Information organized and accessible, maintains efficient workspace, manages time well.
  • Problem Solving: Displays ability to recognize a problem, trouble shoots to ascertain the extent of the problem, and selects appropriate alternative to investigate or resolve the problem.

Physical, Mental, Environmental & Working Conditions

This role requires significant sitting and typing, moderate walking and writing, and moderate to significant stress in meeting deadlines and dealing with day-to-day events. The candidate must be self-disciplined and a self-starter, able to work independently with a flexible work schedule.