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Bilingual (Spanish) Commercial Health Call Center Representative

1 hour, 59 minutes ago
United States
Full-time
Junior
Customer Support
Customer and Technical Support
CRM 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 7

Description

  • Research, review, and respond to inquiries from members and providers by phone and email.
  • Handle inbound and outbound calls while delivering an exceptional customer service experience.
  • Provide accurate information on commercial health plan benefits, eligibility, claims, and claim payments.
  • Use active listening, patience, and empathy to manage difficult calls professionally.
  • Escalate issues, manage complaints and appeals, and follow through to resolution.
  • Coordinate problem-solving with internal departments, vendors, business partners, and providers.
  • Document all calls accurately and maintain production, quality, attendance, and schedule adherence standards.
  • Identify trends in call types and recommend process improvements to leadership.
  • Assist members with navigating the member portal and encourage self-service use of company tools.
  • Participate effectively in virtual team huddles, 1:1s, check-ins, and instant messaging communication.

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, and Appeals and Grievance or similar operational 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.
  • Strong attention to detail, problem-solving ability, and high accuracy in a fast-paced, deadline-oriented environment.
  • 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 either the CST or EST time zone.
  • Ability to maintain a dedicated private work area, keep sensitive documents secure, and have access to high-speed internet.

Benefits

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

Interested in this position?

Apply directly on the company website

Apply Now

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