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Bilingual (Spanish) Commercial Health Call Center Representative - Remote

1 hour, 34 minutes ago
United States
Full-time
Junior
Customer Support
Customer and Technical Support
Salesforce
Apply Now
Evry Health

Evry Health

Evry Health is a modern health insurance company that prioritizes delivering great benefits at affordable prices. They offer a unique approach to health insurance by focusing on making members healthier and happier through personalized care from a dedi...

Insurance
11-50
Founded 2017
$7M raised
View All Jobs 6

Description

  • Research, review, and respond to inquiries from members and providers by phone and email.
  • Handle inbound and outbound calls with patience, empathy, and professionalism.
  • Manage escalations and follow issues through to resolution with clear accountability and urgency.
  • Use company policies, benefits, claims, eligibility, and billing guidelines to provide accurate responses.
  • Handle member complaints and complaint appeals.
  • Coordinate problem solving with internal departments, vendors, business partners, and providers.
  • Document all calls accurately and maintain production and quality standards.
  • Identify trends in call types and share suggested solutions with leadership.
  • Help members navigate the member portal and encourage self-service.
  • Participate actively in virtual team huddles, one-on-ones, instant messaging, and check-ins.

Requirements

  • At least 2 years of customer service experience supporting a commercial health plan, not Medicare, Medicaid, or Pharmacy only.
  • Experience collaborating with Claims, Medical Management, Appeals, or Grievance teams.
  • Knowledge of medical and insurance terminology, including CPT, ICD-10, HCPCS, and revenue codes.
  • Excellent verbal and written communication skills with the ability to explain complex topics clearly.
  • Ability to work in a fast-paced, deadline-oriented environment.
  • Strong attention to detail, problem-solving skills, and a high level of accuracy.
  • Proficiency with Microsoft Office applications such as Word, Excel, Outlook, and OneNote.
  • Prior experience using a CRM, preferably Salesforce.
  • Fluency in both English and Spanish.
  • Must live and work in the United States in the CST or EST time zone.
  • Must have a dedicated private work area and secure handling for sensitive documents.
  • Must have access to an existing high-speed internet connection/service.

Benefits

  • Competitive salary.
  • Comprehensive health, dental, and vision insurance, plus life and disability coverage.
  • Retirement savings plan with company match.
  • Generous time off/vacation.
  • Professional development opportunities.
  • Flexible remote work environment.

Interested in this position?

Apply directly on the company website

Apply Now

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