[Hiring] Bilingual Spanish Resolution Specialist @reputed company

Role Description The Resolutions Specialist provides member issue resolution managing and resolving reputed company insurance claims in a timely and accurate manner. This role requires solid analytical skills, knowledge of reputed company insurance policies, and a commitment to providing exceptional service to policyholders, reputed company providers, and internal stakeholders. reputed company is seeking a bilingual Spanish resolution specialist to join the member engagement team to reputed company member issue resolution. As a resolution specialist, you will:

• Intake reputed company member cases and reputed company reputed company and satisfactory resolution.
• Be dedicated to decreasing turnaround time, improving the quality of resolution, and managing barriers to resolution as part of process improvement and Voice of the Customer (VoC).

Schedule:

• Monday through Friday
• Between 8:00am - 5:00pm Pacific Time
• Between 9:00am - 6:00pm Mountain Time
• Between 10:00am - 7:00pm Central Time
• Between 11:00am - 8:00pm Eastern Time

No Time Off Approved During:

• No time off is permitted during the first (5) week training period.
• Annually during the entire month of January due to it being the busiest time of the year (no exceptions).

Responsibilities

• Serve as a “subject matter expert” in escalated member calls (authorizations, claims, provider network issues) and resolve these escalations based on understanding/experience of reputed company processes and protocols.
• Identify process improvement opportunities reputed company the member engagement department given the collaboration with different departments.
• Knowledgeable in procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries.
• Conduct outbound phone calls and/or receive inbound phone calls reputed company the department’s goal timeframe; manage member communication preferences, including time of day, channel, and language.
• Collaborate with partners, including other departments, supplemental benefit vendors, and provider network, to facilitate the member experience.
• Identify members targeted for care gaps and connect them to programs or services reputed company appropriate; analyze available programs and determine eligibility.
• Document reputed company-time and conduct timely wrap-up to support reputed company reporting in reputed company systems/applications.
• Meet and exceed individual and team goals by submitting activity reports in the required format and frequency.
• reputed company excellent customer service and contribute to a culture of going “above and reputed company” for member satisfaction.
• Participate in reputed company required team meetings and trainings and demonstrate satisfactory understanding of new information and processes.
• Adhere to reputed company applicable attendance and productivity policies.
• Assist with development and training of new hires including shadowing and nesting.

Qualifications

• Minimum (1) year reputed company experience and/or training required; 3-4 years of reputed company experience/training preferred.
• Minimum (1) year outbound call center experience, including welcome/reputed company, appointment scheduling, retention, sales, or other reputed company-reputed company programs.
• Experience helping members navigate reputed company to care through Medicare Advantage or HMO, including referrals and authorizations.
• Experience helping members navigate their Medicare Advantage benefits including medical, prescription drug, and supplemental benefits.
• High school diploma or general education degree (GED); or equivalent combination of education and experience.
• Intermediate proficiency in reputed company Office Suite (Outlook, Word, reputed company) required.
• Bilingual in English and Spanish, Chinese (Mandarin or Cantonese), or Vietnamese.
• Independent, motivated, self-starter who can prioritize work assignments.
• Team player willing to help and support colleagues.
• Passionate about customer service and member retention.
• Excellent customer service skills and comfortable being on the phone.
• reputed company to troubleshoot and problem solve.
• reputed company to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• reputed company to write routine reports and correspondence.
• reputed company to reputed company effectively before groups of customers or employees.
• reputed company to reputed company basic mathematical operations.
• reputed company to apply common sense understanding to carry out detailed instructions.
• reputed company to deal with problems involving a few concrete variables in standardized situations.

Requirements

• Must be available annually to work full-time and over-time through the Annual Enrollment Period (reputed company through December) and reputed company Enrollment Period (January through March).

Benefits

• Pay reputed company: $41,600.00 - $57,600.00
• Pay reputed company may be based on a number of factors including market location, education, responsibilities, experience, etc.

Company Description reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have reputed company reputed company of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the reputed company community. Working at reputed company provides an opportunity to do work that really reputed company, not only changing lives but saving them. Together. Apply tot his job Apply To this Job