Insurance Service Technician

Triple-S Management Corp.; Puerto Rico; Hybrid; USD 32,000 - 46,000; Full time

Job summary

Triple-S Management Corp. is seeking candidates for an entry-level administrative role in Puerto Rico. You will learn and follow procedures to support office operations, handle calls with insured prospects, and document information in OnBase and LifePro systems.

Responsibilities include data entry, verifying eligibility, and assisting agents and departments with pending requests. Strong communication and organizational skills are essential.

Qualifications

• Associate's degree or 60–64 credits with 6–12 months experience in data entry and customer service.
• LOMA entry-level course preferred.
• Experience in life insurance or healthcare administration is a plus.

Responsibilities

• Conduct telephone interviews to collect personal and health information.
• Record and save data in OnBase using the Unity Form.
• Verify eligibility based on questionnaire responses and refer qualified cases to the appropriate area.
• Document call attempts and notes in LifePro.

Skills

Data entry

Customer service

Telephone interviews

Education

Associate's Degree

Tools

OnBase

LifePro

Unity Form

Job description

At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.

When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.

JOB SUMMARY

Requires the ability to learn and follow job instructions and, or procedures. Performs a variety of routine, limited-scope tasks that support office administrative processes, following specific and detailed processes and under direct supervision. Includes contact with the public.

ESSENTIAL FUNCTIONS

• Makes and receives calls from insured prospects to conduct a telephone interview (PQ) where they confirm their personal and health information.
• Use the Unity Form to collect the information and record and save the data in the OnBase system.
• Filter the prospect's information and decide if the prospect meets the requirements to be covered, based on responses to the questionnaire. Refer the document of those who comply to the new business area.
• Document phone call attempts in the system in cases of not contacting the customer.
• If unable to contact the prospect after the third call attempt on different days and times, notifies the district office or the independent agent of the case via email about the efforts made.
• Record notes related to the status of the interview in the Lifepro system.
• Provides support with correspondence returned by department mail.
• Reports to supervisor daily the number of PQs performed.
• Meets performance metrics (calls received, abandoned calls, handling time) based on the Contact Center platform.
• Receives new requests and, or pending requirements via email or physical documents.
• Accesses various websites of our medical service providers to obtain exams and test results for prospective insureds.
• Scans documents received through different submission channels and uploads them to OnBase for proper processing.
• Requests additional medical requirements from our medical service providers when necessary.
• Assists agents from regional offices and independent agencies via email, phone, or in person with pending or in-process requests or any issues they may present; if unable to assist, refers them to the appropriate department.
• Documents important information in the LifePro system regarding conversations held with agents or agency staff.
• Coordinates and provides the Marketing Department with a biweekly report of pending agency requirements for proper follow-up.
• Keeps the file of pending requests up to date, following up with agencies via email and canceling any request that, after approval, lacks required documentation for issuance within a 30-calendar-day period.
• May register, evaluate, and issue non-medical applications.
• Provides support to division staff and other departments as needed.
• Other tasks related to the position.

EDUCATION

• Associate's Degree

EXPERIENCE

Associate's Degree or at least 60 to 64 credits from a recognized university or college, with six (6) months to 1 year of experience in data entry and customer service. Or instead, 1-3 years of experience in the essential functions of the position. Preferably with the Life Office Management Association (LOMA) entry-level course.

LICENSES AND CERTIFICATIONS

• None required

COMPETENCIES

• Action Oriented
• Manages Ambiguity

It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.

Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.