Customer Service Representative - Bilingual

Job Description:

Under the direct supervision of Operation Supervisors, the Customer Service Representative is responsible for supporting a diverse membership community and their providers as well as other customers in a timely manner. This includes inbound and outbound engagement with members and/or providers via phone calls or correspondence regarding benefits, eligibility, or customer issues.

Must be bilingual (English/Spanish) and demonstrate the ability to perform the responsibilities of the position in either English or Spanish language.

Responsibilities:

• Conduct Welcome Calls to new members and perform Health Assessment Surveys as needed. • Provide member education and assists members with Primary Care Physician (PCP) selection and assignments. • Assist with access to care and wellness programs. • Demonstrate passion for providing superior customer service to our members and continually seek to understand the needs of those we serve. • Follow internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures. • Create accurate and timely documentation concerning all inquiries taken in accordance with established protocols to ensure resolution is provided and presented in a clear and accurate manner. • Present and project a positive image of the company in and out of the office to fellow associates, members, providers and the community by being courteous, helpful, energetic, respectful and polite. • Strive to resolve an inquiry on first contact while ensuring that the inquiries have been addressed to the customer’s satisfaction by using all resources in an efficient and timely manner. • Provide feedback and/or solutions to supervisor to ensure continuous process improvement and provide better customer experience. • Create and support an environment which fosters teamwork, cooperation, respect and diversity. • Maintain an awareness of all product knowledge information. • Able to respond positively to support change within the department and the company. • Routinely meet or exceed contact center key performance indicators. • Perform other duties as assigned.

Scheduling / Shift: This full-time role operates within our core operational hours of 8 AM to 8 PM, Monday through Saturday. The ideal candidate will be flexible to work shifts within this timeframe, including weekends. Shift start times: 9:30AM, or 10:30AM.

• Hybrid schedule – Tuesday and Wednesday being the required days in office.

Education & Experience requirements:

• High School Diploma or GED. • 1-year of prior customer service experience. • Experience in the healthcare or managed care industry is preferred but required. • Proficiency in PC applications within a Microsoft Windows environment. • Demonstrated verbal and written communication skills combined with listening and problem-solving ability to identify needs, seek solutions and resolve customers’ concerns. • Ability to work well in a team environment and willingness to learn and adopt customer service methods and practices.