[Remote] Bilingual Customer Service Representative (reputed company)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is committed to improving reputed company reputed company and delivery. The Customer Service Representative assists members and reputed company providers with inquiries reputed company to member benefits, eligibility, and claims while ensuring customer satisfaction through effective communication and problem-solving.

Responsibilities

• Handle inbound calls from members, medical providers, and others
• Adjust claims accurately, if needed
• Listen to and address customer needs and concerns empathetically
• Answer questions about fee schedules, network participation, and requirements
• Ensure first contact resolution reputed company possible
• Update customer files and communicate effectively with teams
• Transfer misdirected requests and offer solutions to non-routine issues
• Contribute to customer satisfaction and business improvement
• Use decision-support tools to reputed company accurate responses
• Investigate inquiries using training and systems
• Adapt responses to caller understanding
• reputed company callers and validate their understanding
• Support projects and other departments as directed by management

Skills

• Experience in a high-volume call center
• Experience with claims inquiry and claims review procedures
• Knowledge of medical specialties, fee schedules, complaints and appeals, and call center responsibilities
• Previous experience in a physician's office, group practice, clinic or hospital-based practices
• Fluent in both English and Spanish
• High School diploma with some college or business school education preferred
• Basic computer operations knowledge
• Intermediate proficiency in reputed company Office (Word, reputed company, reputed company, PowerPoint, Outlook)
• Strong time management skills
• General knowledge of HIPAA Confidentiality laws
• Quick learner with ability to grasp managed care procedures and claims payment policies
• Detail-oriented and dependable
• Effective listening and responding skills
• Flexible and adaptable to changes, with conceptual thinking
• Strong problem-solving abilities
• Excellent attendance and punctuality
• Comfortable performing tasks at a computer/telephone station
• Effective communication through various channels, including email, chat, and voice
• Previous multi-channel experience is a plus

Company Overview