About this role
About the Role The Bilingual Healthcare Customer Service Representative will work remotely from Florida, supporting Gainwell's clients by handling inbound calls related to insurance and healthcare, and guiding members and providers toward accurate resolutions. This role operates within 7:00 AM – 6:00 PM center hours and is a full-time, 40-hour-per-week telework position. Video cameras must be used during all interviews and during the initial week of orientation. What You'll Do
- Answer telephones and respond to basic customer questions or route to appropriate personnel, providing consultancy using knowledge of insurance and healthcare.
- Develop and implement general insurance and health care policies in accordance with state and federal laws; investigate and adjudicate claim characteristics that do not match policy provisions.
- Respond to provider appeals and meet with providers to resolve problems/issues.
- Advise provider review councils, state officials, and collaborate with organized healthcare groups on various medical issues related to insurance and healthcare programs.
- Process calls to meet or exceed service level agreements (SLAs).
- Record calls, process requests, and update account history with results of inquiries, including proper documentation.
- Interface with team members, management, and customers on customer service issues; review and modify procedures/workflows for efficient processing of transactions. What We're Looking For
- Bilingual proficiency in English and Spanish is required.
- 2+ years of customer service experience in any industry.
- Knowledge of basic help desk software, computer software, and Microsoft Office.
- Strong problem-solving skills to bring inquiries to effective resolution.
- Strong customer service skills with an emphasis on written and oral communication.
- Ability to understand your role on a team and identify the correct stakeholders to consult to resolve client inquiries. Compensation & Benefits
- Salary range: 37,440 - 41,600 per year.
- Remote (work from home) role with a 40-hour work week.
- All salaried, full-time employees are eligible for a generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance.
- Additional development opportunities include leadership and technical academies to build skills.