Customer Service Representative - Bilingual (Spanish)

Join us for an exciting career with the leading provider of supplemental benefits!

Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

As a Bilingual Customer Service Representative your duties revolve entirely around providing empathy and compassion to Avesis’ Members, Customers, and Provider relationships. Responsibilities include, but are not limited to, developing and enhancing relationships, responding to inquiries, and investigating, analyzing, and resolving issues for our members. You will assist with eligibility verification, pre-authorizations, denials, along with claim status and payment amounts regarding their Dental, Vision, and ancillary benefits. This work will all be done using our internal Avesis resources and online portals. Bilingual CSRs will be responsible for providing world-class customer service and maintain complete and accurate documentation of all interactions. Our chosen candidates will demonstrate responsiveness and a sense of urgency while resolving customer concerns and inquiries and maintain a high level of productivity and service quality standards while continually supporting individual, team, and company goals and initiatives.

**All Hires for This Role Will Start on Monday, December 9th, 2024**

Essential Job Functions:

• Answer 40-60 inbound calls per day, responding to inquiries ranging from routine to moderate complexity.
• Capture member information accurately and update systems with complete and concise data.
• Ensure flexibility, stay organized, and comply with constantly changing programs and business rules.
• Investigate issues that cannot be resolved at the time of initial call. Collaborate with internal teams to research and follow up with the Member until a resolution occurs.
• Comfortable working in the healthcare field, with an acute awareness for privacy, confidentiality and professionalism.
• Ability to determine proper issue escalation - joining forces with other internal departments for answers, therefore closing the loop and providing a solution for the Member.

Requirements:

• Fluent (Speaking, Reading and Writing) in English and Spanish REQUIRED.
• High School Diploma or equivalent required.
• Minimum 6 months experience working in a high volume, call center environment required
• Healthcare call center customer service experience highly desired.
• Exposure to Medicare, Medicare Advantage, or Medicaid insurance claims preferred.
• Ability to work 40+ hours/week, Monday - Friday, with availability between 7:00 a.m. and 9:00 p.m. Eastern Time required.
• Capacity to work unencumbered and independently in a home office/virtual environment required.
• Internet connection must be through a cable broadband or fiber optic internet service provider with speeds of at least …