Health Insurance Customer Support Specialist (Inbound)

MCS Health; San Juan (PR); On-site; USD 32,000 - 42,000; Full time

Job summary

MCS Health in San Juan, Puerto Rico, seeks a Customer Service Representative to handle inbound calls from policyholders, members, and providers, ensuring high-quality service and accurate documentation.

You will follow call protocols to deliver quality service, aim for first call resolution, and document interactions to support service continuity and HIPAA compliance. Bilingual basics in Spanish and English are expected, with rotating shift availability including weekends.

Qualifications

• Experience in customer service, preferably in a call center in health insurance.
• Knowledge of data privacy and HIPAA-related policies is desirable.
• Strong keyboard and telephone etiquette is expected.

Responsibilities

• Handle inbound calls from policyholders, members, and providers and resolve inquiries per established processes.
• Maintain confidentiality and proper handling of information per HIPAA and privacy policies.
• Meet KPIs including productivity, schedule adherence, call handling, and documentation accuracy.
• Support operational efficiency and service quality through participation in improvement initiatives.
• Provide feedback to identify service gaps and process inefficiencies observed during interactions.
• Adhere to scripts, policies, and guidelines to ensure compliant service delivery.
• Utilize the telephone system in line with assigned schedules to support performance metrics.

Skills

HIPAA knowledge

Inbound call handling

Data entry

Education

Bachelor's Degree

Sixty college credits

High School Diploma

Job description

MCS Health in San Juan, Puerto Rico, seeks a Customer Service Representative to handle inbound calls from policyholders, members, and providers, ensuring high-quality service and accurate documentation.

You will follow call protocols to deliver quality service, aim for first call resolution, and document interactions to support service continuity and HIPAA compliance. Bilingual basics in Spanish and English are expected, with rotating shift availability including weekends.