What are the responsibilities and job description for the Driscoll Health Plan - Bilingual Customer Service Representative position at Driscoll Health System?
General Purpose of Job:
The Bilingual Customer Service Representative is responsible for the assisting Member/ Provider with healthcare inquires concerns, or complaints via telephone.
Essential Duties and Responsibilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or health plan administration, as required.
General Duties:
- Respond to member/provider inquiries via telephone regarding health insurance benefits, eligibility and claims.
- Analyze problems and provide correct information and solutions.
- Communicate monthly messages to providers on a specific needs basis.
- Deal tactfully and empathetically with customers.
- Establish and maintain effective working relationships with physician office staff.
- Read, comprehend and verbalize processes and procedures of the organization and of health insurance coverage.
- Multi-task and pay close attention to detail.
Education and/or Experience:
- Minimum of a high school diploma or equivalent
- Prior experience in Customer Service in a Managed Care Organization preferred
- Ability to type a minimum of 35 words per minute
- Knowledge of managed care processes and health insurance coverage preferred
- Outstanding communication skills and the ability to understand complex situations to effectively handle escalated customer needs
- Analytical skills and the ability to read and interpret data
- Problem solving abilities
- Ability to work independently and as a part of a team
- Ability to operate computer programs - Microsoft Word, Microsoft Excel, Microsoft PowerPoint
- Must be Bilingual in Spanish
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