Remote Customer Service Representative - Bilingual Spanish

VXI Global Solutions is a trusted leader in healthcare services, seeking a Spanish Bilingual Healthcare Call Center Representative. In this role, you will provide exceptional customer support to members, helping them navigate their healthcare options while ensuring compliance and maintaining high service quality.

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