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Bilingual - Spanish Call Center Associates

Fully Remote, Fully Remote
Spanish & English - Call center Representative

Responsible for inbound phone inquiries primarily dealing with either:
  1. Member benefits and eligibility related to the Medicaid, CHP and FHP product lines or
  2. Provider benefits, eligibility, PEP and claim status, member pharmacy calls, utilizing prior approval skills (ACP/DME and CCD) and placing outbound calls on a routine basis.

Resolve issues with respect to benefits and eligibility by researching documentation, system information or gaining knowledge from other employees, management or departments. 

Interact with customers, document call specifics and demonstrate quality program behaviors to create an outstanding relationship with each caller.

Work with outside vendors as needed to answer questions or resolve issues.

Respond to member correspondence/email in writing utilizing an existing Customer Service system letter to effectively respond to members.

Conduct orientation to new members by providing an overview of the member’s plan and pertaining administrative policy.

Demonstrate awareness, motivation, and technical skills to assist in the development and growth of the customer service teams and help to identify process improvements.

Assist in department/company projects, as needed, i.e.  provide feedback about the customer’s experience.

  • High School Diploma, GED, or Equivalent work experience
  • Must be computer literate and able to multi-task – i.e. document call experience while using the Quality Program.
  • Excellent communication and interpersonal skills.
  • Bilingual fluency in English and Spanish

Preferred Qualifications:

  • Healthcare/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)
  • Social work, behavioral health, disease prevention, health promotion and behavior change  (working with vulnerable populations)
  • Sales or account management experience
  • Customer Service Experience
Priyanka s

Companies across U.S. have engaged ReqRoute, Inc to deliver skilled, dedicated IT professionals. Recruiting is our passion and we support Fortune 1000 companies with their hiring needs. We always seek to deliver competitive and sought-after career opportunities to our potential consultants and employees. We invite you to review the position requirements and apply today if your skills match our needs.  
ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. (www.reqroute.com)

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