Remote USA

Important things YOU should know:

Must be fluent in Spanish
Fully Remote Role
Training Schedule: 8:00am -4:30pm CST Monday – Friday
Work Schedule: 8:00am - 4:30pm CST with potential to flex
Hours of operation: 7:00am - 8:00pm CST so shift could flex based on business need
$2/hour differential on Mon/Tues
Exceptional Professional Growth

What will YOU be doing for us?

Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience.

What is in it for YOU?

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

What will YOU be working on every day?

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.

Additional Responsibilities:

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.

What qualifications do YOU need to have to be GOOD candidate?

Required Level of Education, Licenses, and/or Certificates
High school diploma or equivalent
Required Level of Experience
1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail
Required Knowledge, Skills, and Abilities
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
Leverage knowledge and resources to provide the appropriate solutions

What qualifications do YOU need to be a GREAT candidate?

Preferred Level of Experience
1+ years of job related customer service experience within the dental, vision or medical industry
Previous experience working in a virtual environment
Understanding of dental, vision and/or medical insurance terminology
Previous call center experience

The salary range and midpoint is listed below for your reference. Please keep in mind that your education and experience along with your knowledge, skills and abilities are taken into consideration when determining placement within the range.

Compensation Range:

$32,461.00 - $48,691.00

Compensation Midpoint:

$40,576.00

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