Bilingual Customer Service Representative - Managed Care
Atlantic City, NJ
*** This is a Full-Time, Benefits Available, CONTRACT-TO-HIRE position expected to convert to a Permanent / Direct-Hire role after an established time frame! ***
Customer Service Representative Job Summary:
** Requires Bilingual in English and Spanish **
Customer Service Representative Background:
- Be the face of the self-insured health fund, especially to members and to provide benefit, eligibility, claim and health care education, information and issue resolution to a multi-cultural community
- Serves as the main point of contact for the Fund’s members, unions, employers, providers, and vendors on benefit, claims and eligibility issues, education and questions
- Receives and records telephone and walk-in inquiries regarding plan benefits, claims and eligibility
- Performs enrollment functions, including telephonic and in-person outreach
- Encourages members to take steps to get involved in programs to improve their health Recognizes and communicates issues to management including trends and anomalies
- Researches benefit, eligibility and claim issues and initiates corrective action with relevant departments
- Maintains up-to-date knowledge of all systems and sources relating to plan benefits, processes, policies, etc. that will affect performance of daily tasks
- Assists in member outreach, including telephonic and face to face in the Fund office, union office and worksites
- Requires an education level of at least an Associate degree in Healthcare or related field; or equivalent work experience.
- Around 1-2 years’ customer service experience with at least 6 months experience in an office setting, call center setting, or phone support role.
- Healthcare experience is preferred, including basic familiarity with medical terminology.
- Computer skills to include Microsoft Word, Excel and basic data entry, including the ability to learn new and complex computer system applications.
- Must test at a minimum of 35-40 wpm typing with a high level of accuracy.
- Requires candidates Bilingual in English and Spanish