Bilingual Spanish Resolution Specialist

Role Overview

• Provide member issue resolution managing and resolving healthcare insurance claims.
• Intake complex member cases and provide prompt and satisfactory resolution.
• Decrease turnaround time, improve the quality of resolution, and manage barriers to resolution.
• Serve as a subject matter expert in escalated member calls.
• Identify process improvement opportunities within the member engagement department.
• Conduct outbound phone calls and/or receive inbound phone calls.
• Collaborate with partners and other departments to facilitate the member experience.
• Document real-time and conduct timely wrap-up to support outcomes reporting.

Requirements

• Minimum (1) year healthcare experience and / or training required; 3-4 years of healthcare experience / training required.
• Minimum (1) year outbound call center experience.
• Experience helping members navigate access to care through Medicare Advantage or HMO.
• Experience helping members navigate their Medicare Advantage benefits.
• High school diploma or general education degree (GED); or equivalent combination of education and experience.
• Intermediate proficiency in Microsoft Office Suite (Outlook, Word, Excel).
• Bilingual English and Spanish, Chinese (Mandarin or Cantonese), or Vietnamese.
• Independent, motivated, self-starter who can prioritize work assignments.

Benefits

• Health insurance
• Retirement plans
• Paid time off
• Flexible work arrangements
• Professional development opportunities