Handle inbound and outbound calls from members, providers, and other stakeholders
Research claims, verify insurance, and resolve inquiries
Accurately document all interactions in the system and ensure records are updated and complete
Maintain confidentiality and ensure compliance with HIPAA and other healthcare regulations
Escalate complex issues to supervisors or appropriate departments when necessary
Meet or exceed performance metrics including call quality, handle time, and customer satisfaction
Provide exceptional customer service and a positive patient experience
Requirements
Bilingual (English/Spanish) with ability to speak, read and write proficient English/Spanish
High school diploma or equivalent required; associate degree or healthcare certification preferred
1+ year of experience in a call center or customer service role, preferably in a healthcare setting
Ability to multitask and navigate multiple systems simultaneously
Proficiency in Microsoft office and call center software
Familiarity with medical terminology and insurance processes is a plus
Ability to remain calm and professional in high pressure situations
Maintain confidentiality and comply with HIPAA and other healthcare regulations
Benefits
generous, flexible vacation policy
401(k) employer match
comprehensive health benefits
educational assistance
leadership and technical development academies
work flexibility
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
call center experiencecustomer servicemedical terminologyinsurance processesmultitaskingdocumentationperformance metricsHIPAA compliancebilingual (English/Spanish)proficiency in Microsoft Office
Soft skills
communicationproblem-solvingcalm under pressureattention to detailcustomer satisfactioninterpersonal skillsorganizational skillsadaptabilityprofessionalismconfidentiality
Certifications
high school diplomaassociate degreehealthcare certification