Bilingual Call Center Representative

November 4

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iCareManager

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Assisted Living Software • EHR Software • Long Term Care Software • Health Care Software • EMR Software

51 - 200

Description

• Direct communications with members, providers, and health plans • Confirmation of benefits and eligibility information to members, providers, and health plans • Provide confirmation of participating providers in the network • Provide claim status to members, clients, and providers • Resolve problems by identifying the customer's complaint, selecting and explaining the best resolution for the issue; escalate to upper management when necessary • Keep managers informed of any issues that may require their attention to avoid or resolve an existing problem • Apply knowledge, experience, common sense, and critical thinking to all issues being dealt with. • Multi-task and prioritize • Respond to general inquiries from members and providers (plan benefits, limits, co-pays, deductibles, policy procedures, reimbursements, etc.). • Redirect callers when necessary • Follow up until completion on all issues that are not resolved on the initial contact, and keep parties updated on steps and actions taken • Service the maximum number of callers in the quickest and most efficient way without sacrificing the quality of the service

Requirements

• 1+ year of Member Services experience in the Healthcare industry • Proficient with computers • English and Spanish bilingual