Bilingual Spanish Resolution Specialist

Job Summary

Dedicated to resolving member issues, the full-time Bilingual Spanish Resolution Specialist will manage healthcare insurance claims, conduct member outreach, and collaborate with various departments to enhance the member experience in a fully remote setting.

Key responsibilities

• Serve as a subject matter expert for escalated member calls, resolving issues related to authorizations, claims, and provider networks
• Identify and implement process improvement opportunities within the member engagement department
• Document member interactions accurately and meet individual and team goals for customer satisfaction

Required qualifications

• Minimum of 1 year of healthcare experience and/or training; 3-4 years preferred
• At least 1 year of outbound or inbound call center experience related to healthcare
• Experience assisting members with Medicare Advantage benefits, including referrals and authorizations
• High school diploma or GED, or equivalent combination of education and experience
• Bilingual proficiency in English and Spanish required; additional language skills a plus