America's Job ExchangeAJE

Company in the Cerritos, Long Beach area is looking to hire the best BILINGUAL SPANISH call center/customer service reps in the area!

Minimum requirements:
1. 3 to 5 years of call center in a medical insurance setting
2. Bilingual Spanish
3. Must have excellent verbal and written communication

Member Services Representative

Job Description:

To serve as a liaison between the company and its members. Ensures that all members receive a level of service that exceeds their expectations. Using three methods of communication (inbound and outbound calls, written correspondence. Respond and resolve questions and problems from current/prospective members, or their representatives, providers, and other appropriate parties.

Be proficient in discussion and execution including, but not limited to the following:

Benefit clarification/eligibility verification/claim status.
Medical group/PCP, dental and vision provider assignments.
Explanation of how the plan works and how to utilize the services.
Assist with information regarding referral or authorization.
Change of provider/member information.
Any complaints/grievances.
Identification card requests.
Update new member eligibility on appropriate systems.
Perform overrides for covered/authorized prescriptions as needed.
Participate as team player by demonstrating support to peers, management, and the departments goals. Attend meetings and training sessions as scheduled.
Document all member inquires and complaints in appropriate systems and either handle, redirect, or defer to the appropriate department for resolution.

Excellent benefits and compensation package, as well as growth opportunities.


Job Experience:

BILINGUAL SPANISH
EXCELLENT USE OF MS WORD AND EXCEL
DEGREED PREFERRED