REMOTE Call Center Representative

Bilingual Call Center Representative (English/Spanish)

100% Remote

Schedule: Monday–Friday, shifts available between 8:45am-8:15pm EST

Start Date: September 8th

Contract Type: 6-Month Contract-to-Hire

Overview:

We are seeking a dedicated and bilingual (English/Spanish) Call Center Representative to join our remote team. This role is ideal for someone who thrives in a fast-paced environment and is passionate about delivering exceptional customer service.

Key Responsibilities:

• Handle inbound calls from members and providers regarding eligibility, benefits, claims, and service authorizations.
• Accurately respond to inquiries and resolve customer service or billing issues using sound judgment.
• Contact customers to provide updates on complex inquiries or claim investigations.
• Escalate unresolved grievances, appeals, and claims to the appropriate departments.
• Maintain detailed records of customer interactions and transactions.
• Actively listen and ask probing questions to fully understand caller needs.
• Research and communicate information about member eligibility and claim status.
• Educate providers on claim submission processes and treatment plan requirements.
• Follow up to ensure all member or provider needs are addressed.

Requirements:

• Bilingual in English and Spanish (preferred)
• Strong communication and problem-solving skills.
• Ability to work independently in a remote environment.
• Previous call center or customer service experience preferred.