Health Insurance Customer Support Specialist I

MCS Puerto Rico; Caguas (PR); On-site; USD 28,000 - 36,000; Full time

Job summary

MCS Puerto Rico is seeking a Customer Service Representative I – SC to assist customers with information about health products and services. You will resolve routine needs by following established processes and documenting interactions to ensure continuity of offerings by the Service Center.

The role requires handling inquiries on policyholder eligibility, benefits, and claims, updating demographics, logging cases in the CRM, and coordinating with other departments to support customer retention.

Qualifications

• Bachelor’s degree, or equivalent education, required.
• 1 year of experience in customer service, preferably health insurance call center.
• 60–64 college credits / Associate’s degree with 1 year of health insurance customer service preferred.
• High school diploma with 2 years of customer service experience preferred.

Responsibilities

• Handle and resolve service requests from customers, including inquiries about policyholders and dependents.
• Prepare coverage certifications and letters of non-covered services.
• Maintain updated policyholder demographics in systems.
• Log cases in CRM, inform customers of status, and document steps taken.
• Answer calls from Call Center and ensure follow-up when needed.
• Refer complaints to the appropriate unit and support other departments as required.

Skills

Customer service

Phone etiquette

Keyboarding

Education

Bachelor’s degree

60–64 college credits / Associate’s degree

High school diploma

Tools

CRM systems

Job description

MCS Puerto Rico is seeking a Customer Service Representative I – SC to assist customers with information about health products and services. You will resolve routine needs by following established processes and documenting interactions to ensure continuity of offerings by the Service Center.

The role requires handling inquiries on policyholder eligibility, benefits, and claims, updating demographics, logging cases in the CRM, and coordinating with other departments to support customer retention.