Bilingual Customer Service Representative - Remote

VXI Global Solutions is committed to delivering exceptional customer service in the healthcare sector. They are seeking a Spanish Bilingual Healthcare Call Center Representative to provide comprehensive support to members, providers, and patients, ensuring they maximize their healthcare benefits while adhering to compliance guidelines.

Responsibilities:

• Manage inquiries in areas such as Member Services, Medicare, and Billing, assisting Spanish- and English-speaking customers
• Represent our client professionally by addressing and documenting all incoming queries, including complex calls related to specialized product lines
• Uphold the organization’s philosophy of extraordinary customer relations
• Proactively engage with Health Plan, medical group, and facility personnel to gather relevant information for resolving member inquiries
• Analyze and evaluate customer issues to initiate and coordinate service recovery measures
• Document all member interactions meticulously following established procedures
• Demonstrate familiarity with health insurance terminology (copays, deductibles, claims, authorizations, etc.)
• Understand Medicare/Medicaid plans and regulations, and explain plan benefits, provider networks, and coverage policies
• Leverage a thorough understanding of company policies and processes to meet customer needs effectively
• Contribute to departmental goals and objectives while maintaining proficiency through ongoing training and use of required tools
• Monitor and achieve Contact Center KPIs, including call handling, first call resolution, and member retention
• Consistently uphold company compliance standards and Code of Conduct, ensuring privacy and confidentiality of member information
• Adhere to HIPAA regulations to protect personal health information (PHI) and maintain data security
• Use multiple systems/screens while assisting callers effectively
• Navigate CRM, EMR/EHR, and ticketing platforms effectively

Requirements:

• Fluency in both Spanish and English (spoken and written) is required
• Minimum of two (2) years of customer service or healthcare member-interaction experience
• High School Diploma or GED required
• Outstanding written and verbal communication skills
• Proven analytical and problem-solving abilities
• Ability to respond concisely and clearly to customer queries
• Strong critical thinking and problem-solving skills
• Typing speed of at least 35 WPM with a 5% or lower error rate
• Private Workspace: A dedicated, quiet workspace with a door that closes, free from ambient noise
• Ergonomics: A comfortable desk and chair setup that allows for the proper installation of necessary equipment
• Reliable Internet Connection: Stable, high-speed internet with a minimum bandwidth of 20 Mbps downstream and 20 Mbps upstream
• Quiet, Distraction-Free Workspace: A dedicated, quiet area where you can focus on delivering excellent customer service without interruptions
• Tech-Savvy: Comfort with technology and ability to learn new systems quickly
• Self-motivation & Independence: Ability to stay productive and manage your time effectively in a remote environment
• Communication Skills: Strong verbal and written communication skills, especially in a virtual setting
• Adaptability: Ability to adapt to changing technologies and procedures while working remotely
• Previous call center experience and/or prior experience in the health insurance industry