Bilingual Customer Care Representative

3 days ago

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SKYGEN

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Benefit Management Software • Dental Benefit Management • Vision Benefit Management • SaaS • Provider Data Management

501 - 1000

Description

• 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 • 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

Requirements

• High school diploma or equivalent • 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail • Must be fluent in Spanish • Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook • Ability to work occasional overtime as needed • Excellent listening and communication skills • Superior customer service skills including the natural ability to provide empathy • Strong data entry/typing skills • Strong navigation skills and the ability to multi-task • Excellent attention to detail • Critical thinking skills to quickly analyze and clearly understand a specific request or customer need

Benefits

• Career growth in an inclusive culture • Paid training • Health benefits • 401(k)