[Remote] Bilingual Customer Service Representative (April)

Note: The job is a remote job and is open to candidates in USA. MagnaCare is focused on improving healthcare access and delivery. They are seeking a Bilingual Customer Service Representative who will assist members and healthcare providers with benefits, eligibility, and claims inquiries while ensuring customer satisfaction through effective communication and problem-solving.ResponsibilitiesHandle inbound calls from members, medical providers, and othersAdjust claims accurately, if neededListen to and address customer needs and concerns empatheticallyAnswer questions about fee schedules, network participation, and requirementsEnsure first contact resolution when possibleUpdate customer files and communicate effectively with teamsTransfer misdirected requests and offer solutions to non-routine issuesContribute to customer satisfaction and business improvementUse decision-support tools to provide accurate responsesInvestigate inquiries using training and systemsAdapt responses to caller understandingEducate callers and validate their understandingSupport projects and other departments as directed by managementSkillsExperience in a high-volume call centerExperience with claims inquiry and claims review proceduresKnowledge of medical specialties, fee schedules, complaints and appeals, and call center responsibilitiesPrevious experience in a physician's office, group practice, clinic or hospital-based practicesFluent in both English and SpanishHigh School diploma with some college or business school education preferredBasic computer operations knowledgeIntermediate proficiency in Microsoft Office (Word, Excel, Access, PowerPoint, Outlook)Strong time management skillsGeneral knowledge of HIPAA Confidentiality lawsQuick learner with ability to grasp managed care procedures and claims payment policiesDetail-oriented and dependableEffective listening and responding skillsFlexible and adaptable to changes, with conceptual thinkingStrong problem-solving abilitiesExcellent attendance and punctualityComfortable performing tasks at a computer/telephone stationEffective communication through various channels, including email, chat, and voicePrevious multi-channel experience is a plusCompany OverviewMagnaCare, a division of Brighton Health Plan Solutions, has been a leading and trusted Third Party Administrator for over 30 years. It was founded in 1990, and is headquartered in New York, New York, USA, with a workforce of 201-500 employees. Its website is http://www.magnacare.com.



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