Health Insurance Customer Experience Specialist I

MCS Puerto Rico; San Juan (PR); Presencial; USD 25.000 - 40.000; Jornada completa

Descripción de la vacante

MCS Puerto Rico is seeking a Customer Service Representative I – SC in Puerto Rico. This temporary, non-exempt role handles customer inquiries about policy details, processes coverage certifications, and maintains accurate policyholder data.

The position requires intermediate Spanish and English and offers a frontline opportunity in a health insurance setting. The role involves logging cases in CRM, supporting various lines of business, and ensuring timely follow-up on requests.

Formación

• Bachelor’s degree; 6+ months in health insurance customer service.
• Alternate: 60–64 college credits (2 years) plus 1 year experience.
• Alternate: high school diploma with 2 years customer service experience.

Responsabilidades

• Handle and resolve service requests from customers and prospects about policies.
• Prepare coverage certifications and letters of non-covered services.
• Maintain policyholder demographics in systems.
• Register visitors and assess service needs to determine actions.
• Log cases in CRM and inform customers of outcomes.
• Handle calls from the Call Center; ensure follow-up on unresolved items.
• Refer complaints to the appropriate unit.
• Support other departments with Health Risk Assessments (HRA) calls.
• Comply with policies, laws, and industry regulations.
• Perform other duties as assigned.

Conocimientos

Customer service

Call center

CRM

Documentation

Phone etiquette

Data entry

Problem solving

Bilingual (Spanish/English)

Educación

Bachelor’s degree

60–64 college credits / Associate’s degree

High school diploma

Descripción del empleo

MCS Puerto Rico is seeking a Customer Service Representative I – SC in Puerto Rico. This temporary, non-exempt role handles customer inquiries about policy details, processes coverage certifications, and maintains accurate policyholder data.

The position requires intermediate Spanish and English and offers a frontline opportunity in a health insurance setting. The role involves logging cases in CRM, supporting various lines of business, and ensuring timely follow-up on requests.