Healthcare Customer Support & Claims Specialist

Triple-S; Guaynabo (PR); Sur place; USD 38 000 - 52 000; Plein temps

Résumé du poste

Triple-S in Puerto Rico seeks an individual to independently perform non-routine tasks supporting health services underwriting, renewal and claims, applying procedures under general supervision. The role may involve training others and requires sound judgment in analyzing requests.

You will coordinate with departments to resolve cases, draft English/Spanish documents, and support supervisors. An Associate's Degree and related experience are required.

Qualifications

• Associate's Degree in Business Administration or Marketing completed.
• At least 1 year of experience related to configuration processes or 60 credits with relevant experience.
• If holding a high school diploma, 3 years of related experience required.

Responsabilités

• Support and guide customers who visit or call to handle health coverage requests.
• Process petitions to complete client transactions: payments, maintenance, refunds, claims, and more.
• Analyze requests and coordinate with other departments to resolve cases.
• Evaluate actions on client requests according to applicable laws.
• Draft documents in English and Spanish as needed.
• Assist supervisors with meetings, reports, audits and related tasks.

Connaissances

Action Oriented

Collaborates

Instills Trust

Manages Ambiguity

Customer Delight (Employee)

Formation

Associate's Degree in Business Administration or Marketing

60 university or college credits with one year of experience in configuration processes

High School Diploma with 3 years related experience (configuration processes)

Description du poste

Triple-S in Puerto Rico seeks an individual to independently perform non-routine tasks supporting health services underwriting, renewal and claims, applying procedures under general supervision. The role may involve training others and requires sound judgment in analyzing requests.

You will coordinate with departments to resolve cases, draft English/Spanish documents, and support supervisors. An Associate's Degree and related experience are required.