Bilingual Call Center Representative

Job Summary

To support member services, the full-time Bilingual Call Center Representative will manage direct communications with members, providers, and health plans while confirming benefits, eligibility, and claim statuses remotely.

Key responsibilities

• Handle inquiries from members and providers regarding plan benefits, limits, and policy procedures
• Resolve customer complaints by identifying issues and providing appropriate solutions or escalating as necessary
• Maintain effective communication with managers regarding ongoing issues and ensure follow-up on unresolved matters

Required qualifications

• 1+ year of Member Services experience in the Healthcare industry
• Bilingual in English and Spanish
• Proficient with computers and technology
• Ability to engage effectively in virtual environments
• Strong understanding of health plan terminology preferred