Bilingual Customer Care Rep - Remote - 1st shift!

SKYGEN; Menomonee Falls (WI); Remote; USD 21,000 - 30,000; Full time

Benefits offered by this job

Health benefits

401(k)

Paid training

Career growth

Job summary

SKYGEN in the United States is seeking a Remote Customer Service Representative fluent in Spanish to support Dental and Vision callers, handling eligibility, benefits, authorizations, and claims with empathy. You will work a standard 8:30am-5:00pm CST schedule after training, with potential evenings during Medicare open enrollment; paid training and health benefits are provided.

This role emphasizes problem solving, strong communication, data entry, and the ability to multi-task while

Qualifications

• High school diploma or equivalent.
• 1+ years of customer service experience in healthcare, call center, banking or retail.
• Basic knowledge of Microsoft Office (Word, Excel, Outlook).
• Ability to work occasional overtime as needed.
• Excellent listening and communication skills.
• Superior customer service skills with empathy.
• Strong data entry/typing skills.
• Strong navigation skills and the ability to multi-task.
• Excellent attention to detail.
• Critical thinking to analyze and understand a specific request.

Responsibilities

• Servicing Dental and Vision callers with eligibility, benefit coverage, authorizations, claims, and provider search.
• Apply knowledge of claim adjustments and resubmission to resolve provider requests.
• Provide feedback on high-level claim issues to ensure prompt resolution.
• Support enrollment activities including assigning primary care providers and updating insurance info.
• Act as liaison between our organization and Member Services to resolve eligibility and appeals/grievances.
• Provide updates to providers on credentialing status.
• Educate callers on using the provider web portal and its benefits.
• Ensure all calls are answered per guidelines.
• Document call information and resolution in internal systems.
• Use diffusion techniques to ensure customers feel heard and supported.
• Escalate issues to leadership when appropriate.
• Provide recommendations on system/process improvements to management.
• Keep Provider Relations updated on provider-related issues.
• Participate in departmental projects when applicable.

Skills

Fluent Spanish

Empathy

Listening skills

Problem solving

Data entry

Multitasking

Attention to detail

Customer service

Education

High school diploma or equivalent

Tools

MS Office (Word, Excel, Outlook)

Job description

Important things YOU should know:

• Must be fluent in Spanish
• Fully remote opportunity
• Experience with Dental or Health insurance a preferred plus!
• Training schedule: 8:00am- 4:30pm CST Monday - Friday for the initial 90 days
• Work schedule (after training): 8:30am - 5:00pm CST - Mon - Fri
• Hours of operation: 6:00am - 10:00pm CST so shift could flex based on business need
• Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31
• $2.00/hour differential on Mon/Tues
• Exceptional professional growth in a fun rewarding environment

What will YOU be doing for us?

Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer - always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience.

What is in it for YOU?

• Career growth in an inclusive culture
• Paid training
• Health benefits
• 401(k)

What will YOU be working on every day?

• Servicing our Dental and Vision callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area,
• Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests.
• Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution.
• Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information.
• Act as liaison between our organization and the client's Member Services staff to resolve issues such as eligibility and filing appeals and grievances.
• Provide updates to providers with questions regarding the status of their credentialing application.
• Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available.
• Ensure all calls are answered according to company and client guidelines.
• Accurately document call information and resolution in our internal systems.
• Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported.
• Properly identify issues that need to be escalated appropriately to the leadership team.

Additional Responsibilities:

• Provide recommendations on system enhancements and process improvements to management.
• Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues.
• Participate in departmental projects when applicable.

What qualifications do YOU need to be GOOD candidate?

Required Level of Education, Licenses, and/or Certificates

• High school diploma or equivalent

Required Level of Experience

• 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail

Required Knowledge, Skills, and Abilities

• Must be fluent in Spanish
• Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook
• Ability to work occasional overtime as needed
• Excellent listening and communication skills
• Superior customer service skills including the natural ability to provide empathy
• Strong data entry/typing skills
• Strong navigation skills and the ability to multi-task
• Excellent attention to detail
• Critical thinking skills to quickly analyze and clearly understand a specific request or customer need
• Leverage knowledge and resources to provide the appropriate solutions

What qualifications do YOU need to be a GREAT candidate?

Preferred Level of Experience

• 1+ years of job related customer service experience within the dental, vision or medical industry
• Previous experience working in a virtual environment
• Understanding of dental, vision and/or medical insurance terminology
• Previous call center experience