Bilingual Health Call Center Representative

Job Summary

Fluent in both English and Spanish, the full-time remote Bilingual Health Call Center Representative will manage inbound and outbound inquiries, delivering accurate information on commercial health plan benefits, eligibility, claims, and billing while ensuring a compassionate customer experience.

Key responsibilities

• Researches and resolves member and provider inquiries, meeting department metrics for quality and turnaround times
• Interprets and explains plan benefits and claims processes, providing support for providers and pharmacy inquiries
• Collaborates with internal teams to document and resolve complex issues, while monitoring call trends for leadership

Required qualifications

• High school diploma or equivalent
• 2+ years of customer service experience in commercial health plan support
• Working knowledge of commercial health plan benefits, eligibility, and claims processes
• Demonstrated knowledge of CPT, ICD-10, HCPCS, and Revenue Codes; proficiency in Microsoft 365
• Fluency in both English and Spanish