Bilingual Customer Care Rep II

Important things YOU should know: Must be fluent in SpanishFully remote opportunityTraining schedule: 8:00am- 4:30pm CST Monday – FridayWork schedule (after training): 9:30am – 6:00pm CST Monday - FridayHours of operation: 7:00am - 8:00pm CST so shift could flex based on business needOccasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31$2.00/hour differential on Mon/TuesExceptional 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 culturePaid trainingHealth benefits401(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 CertificatesHigh school diploma or equivalent Required Level of Experience1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail Required Knowledge, Skills, and AbilitiesMust be fluent in SpanishBasic knowledge of Microsoft Office products including but not limited to Word, Excel, and OutlookAbility to work occasional overtime as neededExcellent listening and communication skillsSuperior customer service skills including the natural ability to provide empathyStrong data entry/typing skillsStrong navigation skills and the ability to multi-taskExcellent attention to detailCritical thinking skills to quickly analyze and clearly understand a specific request or customer needLeverage knowledge and resources to provide the appropriate solutions What qualifications do YOU need to be a GREAT candidate?Preferred Level of Experience1+ years of job related customer service experience within the dental, vision or medical industryPrevious experience working in a virtual environmentUnderstanding of dental, vision and/or medical insurance terminologyPrevious call center experience

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