Insurance Service Technician

Triple-S; San Juan (PR); On-site; USD 30,000 - 42,000; Full time

Job summary

Triple-S is seeking an organized, detail-oriented professional to support office administrative processes in Puerto Rico. The role involves data entry, handling inquiries from insured prospects, and recording information in OnBase and LifePro systems under direct supervision.

The position requires an Associate's Degree or 60–64 credits with six months to one year of data entry and customer service experience. LOMA entry-level course is preferred. Equal opportunity employer.

Qualifications

• Associate's Degree or 60–64 credits from a recognized university or college.
• Six months to 1 year of experience in data entry and customer service.
• LOMA entry-level course preferred.

Responsibilities

• Makes and receives calls from insured prospects to confirm personal and health information.
• Use the Unity Form to collect information and record data in OnBase.
• Filter information to determine coverage eligibility and refer compliant cases to the new business area.
• Document phone call attempts when the customer is not contacted.
• Notify the district office or independent agent after multiple contact attempts.
• Record notes in LifePro regarding interview status.
• Support with correspondence returned by department mail.
• Report daily the number of PQs performed.
• Meet performance metrics on calls received, abandoned calls, and handling time.

Skills

Action Oriented

Collaborates

Instills Trust

Manages Ambiguity

Customer Delight

Education

Associate's Degree

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
• Collaborates
• Instills Trust
• Manages Ambiguity
• Customer Delight (Employee)

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.

We encourage Veterans and Disabled to Apply.